Senior Civil Health Care Fraud InvestigatorEmployment Type: Full Time, Mid-Level
Department: Litigation Support
CGS is seeking a Senior Civil Health Care Fraud Investigator to join our team supporting the legal mission of a large federal agency in Harrisburg, PA. This position will allow candidates to demonstrate expertise in fraud investigations while supporting a federal agency.
Job Description:- Supports the planning and conduction of investigations
- Assists Assistant United States Attorneys (AUSAs) in the investigation of matters in conjunction
with federal agents, to determine whether there have been violations of Federal Statutes, e.g.,
False Claims Act, Stark Law, and Anti-Kickback Act. - Works and regularly communicates with AUSAs to identify possible violations or causes of
action, determines proof required to assist in affixing legal responsibility, and devises methods
for obtaining, preserving, and presenting such evidence - Decides upon the most effective methods for planning, scheduling, and conducting
investigations, and identifies required resources. Recommends methods for conducting
investigations, including interviews, subpoenas, and depositions. Secures participation of
appropriate law enforcement agents in execution of these investigative methods - Identifies and presents AUSAs with potential investigations through review of the news,
databases, and regular communications with representatives of Government agencies and private
industry. - Contacts federal, state, and local officials, as well as business representatives, to gather
information, documents, and statements on current or potential investigations, as well as
coordinate investigative activities. - Assists AUSAs with the identification, locating, and interviewing of witnesses. Conducts
surveillance of suspects with appropriate law enforcement agencies. Communicates with counsel
of subjects and witnesses - Prepares appropriate memos and reports on contacts, interviews, and surveillance
- Examines, analyzes, presents, and secures evidence such as documents, emails, policies, text
messages, payrolls, financial statements, billing statements, invoices, correspondence, computer
data, and other records pertaining to the transactions, events, or allegations under investigation. - Research and reviews laws, rules, regulations, and policies to determine whether health care
billings were improper. Identifies and interviews any relevant Governmental or business
representative pertaining to the propriety of the billings - Traces funds derived from fraud and identifies assets of subjects
- Confirms authenticity of documents, corroborates witness statements, and otherwise builds proof
necessary for successful litigation - Arranges for the integrity of evidence through secure storage, preservation, organization, and
indexing of voluminous physical and electronic evidence. - Regularly updates AUSAs on status of case. Prepares interim and final reports on progress of
investigations for use by AUSAs and supervisory attorneys. Includes significant findings and
conclusions, recommendations for additional investigative actions, and candid assessments of
strengths and weaknesses of witnesses, documentary evidence, and other aspects of case - Assists AUSAs with preparation for litigation and trial
- Provides analytical advice and assistance with compiling documents and physical evidence, and
creating charts, graphs, videotapes, and other audio-visual materials for use by AUSAs in
motions and at trial - Provides advice to AUSA on selection of witnesses and ensures their attendance through
subpoena or otherwise.
Job Requirements:- Bachelor's degree in law enforcement, criminal justice, accounting, finance or related field.
- Minimum ten (10) years of experience in any combination of law enforcement, criminal
justice experience, and health care fraud investigation. - Experience testifying in court matters
- Proficient in Microsoft Office software programs (i.e., Word, Excel, Outlook, etc.)
- U.S. Citizenship and ability to obtain adjudication for the requisite background investigation
- Preferred:
- CPA Certification
- Experience working with a federal or state law enforcement entity
We care about our employees. Therefore, we offer a comprehensive benefits package:
- Health, Dental, and Vision
- Life Insurance
- 401k
- Flexible Spending Account (Health, Dependent Care, and Commuter)
- Paid Time Off and Observance of State/Federal Holidays
Join our team and become part of meaningful government innovation!
Explore additional job opportunities with CGS on our Job Board:
https://cgsfederal.com/join-our-team/
For more information about CGS please visit: https://www.cgsfederal.com or contact:
Email: [email protected]
#CJ
$100,000 - $200,000 a year
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.
