The Senior Financial Analyst/Investigator shall independently plan and conduct health care fraud investigations. Contractor's duties include but are not limited to:
- Develops an understanding of all applicable federal and state laws to the extent necessary to make sound decisions on direction and scope of investigations. Determines proof required to assist in affixing legal responsibility for litigation, and devises methods for obtaining, preserving, and presenting evidence to greatest effect.
- Serves as a participating member of the Health Care Fraud Working Group, and any other task force groups or working groups that USAO SDIL may direct.
- Examines billing statements, invoices, books, ledgers, payrolls, cost reports, correspondence, computer data, and other records pertaining to the transactions, events, or allegations under investigation. Establishes and/or verifies relationships among all facts and evidence obtained or presented to confirm authenticity of documents, corroborate witness statements, and otherwise build proof necessary for successful litigation.
- Reviews billing codes to determine that they are appropriate to the services rendered and properly reflect the time and effort expended by the medical provider.
- Initiates contacts with federal, state, and local officials, and other organizations and individuals related to the subject of investigation, for the purpose of gathering facts, obtaining statements, learning sequences of events, obtaining explanations and otherwise advancing investigative objectives.
- Traces funds derived from fraud and identifies assets of subjects.
- Arranges for the integrity of evidence through secure storage, preservation, organization, and indexing of voluminous physical and electronic evidence.
- Regularly updates Assistant U.S. Attorneys (AUSAs) on the status of cases. Prepares interim and final reports on progress of investigations for use by AUSAs and supervisory attorneys. Reports will include significant findings and conclusions, recommendations for additional investigative actions, and candid assessments of strengths and weaknesses of witnesses, documentary evidence, and other aspects of cases.
- Assists in compilation of documents and physical evidence and the creation of charts, graphs, videotapes, and other materials for use by AUSAs in motions and at trial. Provides advice to AUSAs on selection of witnesses and testifies in court regarding investigations, as required.
Requirements
Job Requirements and Experience
- The Senior Financial Analyst/Investigator shall have at least seven(7) years of relevant medical and/or medical billing or health care fraud investigation experience.
- The contractor shall possess a valid driver's license and the ability to drive in support of investigations.
- Contractor shall have excellent written and oral communication, and familiarity with a variety of computer applications, including word-processing, databases, and spreadsheets.
- The contractor shall have the ability to consistently deliver the highest quality work under extreme pressure.
- Occasional local travel will be required, such as for review of records or interviews.
- Work shall be performed 8 hours per day, Monday thru Friday, except Federal holidays, but with a flexible work schedule due to evening/weekend meetings that may be required.
ADA Requirements
- Operate a PC and phone in an office environment.
- Work in a primarily sedentary position.
- Perform some bending, light lifting, and carrying of equipment may be required.
- Any additional office equipment that is required by the position.
