Overview
Criminal and Civil Health Care Fraud (HCF) Investigator Jobs in Pensacola, FL at KMRG, LLC
Title: Criminal and Civil Health Care Fraud (HCF) Investigator
Company: KMRG, LLC
Location: Pensacola, FL
ROLEWe are seeking an experienced Criminal and Civil Health Care Fraud (HCF) Investigator to support the U.S. Attorney’s Office (USAO) Northern District of Florida (NDFL). Your scope of work focuses on criminal and civil investigations of healthcare matters.
This is a full-time opportunity in which we’ll provide competitive pay, comprehensive benefits, and job stability and security.
Apply today!
Responsibilities
Plan and conduct investigations of complex nature
Perform quantitative, qualitative, or other analysis of relevant facts
Prepare and present the results of analysis findings to support USAO’s mission
Develop an understanding of applicable federal, state, and local laws related to investigations
Work with key stakeholders and agencies (i.e., HHS, FBI, DCIS, and DEA)
Manage cases independently with thoroughness and adherence to investigative protocols
Collaborate with team members to address cases involving sensitive matters or prominent entities
Analyze relevant facts and preparing results to support the USAO’s mission
Research background information using various databases and sources
Identify subjects to investigate., develop leads, conduct interviews, and collect/process evidence
Use analytical skills to identify and obtain financial and health care provider data
Assist with building financial investigations regarding the subjects and their conduct
Prepare reports, charts, graphs, videotapes, exhibits, and other audio-visual materials for hearings and trials
Collect and process evidence
Analyze health care, business, and financial records
Conduct interviews of witnesses
Collaborate with AUSAs, Paralegal Specialists, and supervisory attorneys
Determine applicable statutory and regulatory laws
Identify possible violations and build proof for case resolution
Use electronic databases to identify assets, documents, and other physical evidence
Prepare interim and final reports on progress of investigations (i.e., findings, conclusions, assessments, witnesses, etc.)
Arrange for secure storage, preservation, organization, and indexing of voluminous documentary evidence
Assist in compiling and analyzing documents and physical evidence
Perform other ancillary services as needed to support assigned cases
Help develop efficient methods for conducting investigations and identifying needed resources
Initiate contacts with federal, state, and local officials, organizations, and individuals related to investigations
Gather facts, obtain statements and explanations, and learn sequences of events
Advance investigative objectives through proactive engagement with relevant officials and organizations
Examine records (i.e., books, ledgers, payroll, cost reports, billing statements, invoices, correspondence, computer data)
Establish and verify relationships among facts and evidence
Knowledge & Skills
Knowledge of legal and law enforcement terms and procedures
Knowledge of current investigative techniques (i.e., commercial databases and other sources of info.)
Proficient in word processing, spreadsheet software, and Microsoft Office programs
Excellent written and oral communication skills
Proficient using common software programs (i.e., Excel, etc.) to present data (preferred)
Knowledge of medical billing procedures (preferred)
BACKGROUND
4 years exp. in planning and conducting civil/criminal investigations for misuse of public, private, or insurance funds
Exp. in analyzing, organizing, and…
