Call Center Audits and Investigation (A&I) Fraud Agent - Hybrid - West Sacramento, CA

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.

Summary

A&I Fraud Agents are responsible for responding to basic to moderately complex fraud telephone calls, handling requests for Medi-Cal and In-Home Supportive Services (IHSS) hotlines complaints of fraud, waste, and abuse and conducting stellar customer service.

Your role in our mission

• Answers telephone calls using an automated system and responds to basic beneficiary and provider questions and/or forwards call to appropriate personnel.
• Identify Medi-Cal provider and beneficiary fraud, waste, and abuse, emphasizing fraud prevention in accordance with service level agreements (SLAs).
• Documents calls in a customer relationship management (CRM) ticketing solution, resolves written provider requests/inquiries and updates provider history with results of inquiry to include proper documentation.
• Interfaces with team personnel, management, and customers in reference to customer service issues.
• Conducts outbound calls to providers in response to voicemail inquiries, customer direction or other business needs.

What we're looking for

• High school diploma or G.E.D.
• 6 months minimum, prefer on more years of customer service or other telephone experience.
• Experience working with organizational functions and personnel.
• Experience working with fax machines, computer software and telephone technology.
• Experience working with and skilled in the use of help desk software.

What you should expect in this role

• Business and analytical critical thinking skills.
• Communication skills both written and oral.
• Ability to work independently, follow oral and written directions.
• Ability to navigate Microsoft Word, Microsoft Teams, Microsoft Outlook, and internet browsers.
• The position is hybrid but will be required to work onsite at the West Sacramento Office two to three days per week.

The deadline to submit applications for this posting is August 17, 2026.

The pay range for this position is $31,200.00 - $44,500.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.