COMPLIANCE INVESTIGATOR 1/2/3

State of Louisiana; Baton Rouge (LA); On-site; USD 52,000 - 76,000; Full time

Job summary

Office of Workers’ Compensation in Louisiana seeks a Compliance Investigator 1/2/3 to conduct independent investigations of suspected workers’ compensation fraud. You will analyze claims and records, gather evidence, and prepare cases for prosecutorial referral while maintaining confidential records in line with laws and agency policies.

The role supports OWCA's mission to enforce workers’ compensation laws, enhance early return-to-work outcomes, and deter fraud through the GAME ON task force

Qualifications

• Three years of experience in accounting, auditing, administrative services, building inspection, real estate appraisal, law enforcement, investigations, or in the issuance or recommendation of medical licenses; OR
• Six years of full-time work experience in any field; OR
• A bachelor's degree.

Responsibilities

• Monitor timeliness of responses and recommend penalties based on data.
• Analyze evidence and determine need for criminal or civil action.
• Contact employers in Louisiana to ensure compliance with workers' compensation laws.
• Draft investigative reports for regulatory submission and senior management.

Skills

Investigations

Fraud detection

Data analysis

Evidence handling

Report writing

Interagency cooperation

Education

Bachelor's degree

Tools

Public records databases

Electronic data processing

Job description

Office of Workers’ Compensation

Division: Fraud Claims

Location: East Baton Rouge

Louisiana Works

Louisiana Works transforms lives and drives prosperity by putting people at the center of everything we do. We provide one seamless door where individualized solutions create new possibilities, proving that when government works for people, Louisiana works for everyone.

Role Description

Compliance Investigator 1/2/3 will conduct independent investigations of suspected workers’ compensation fraud and violations of state and federal laws, agency policies, and regulations. The position analyzes claims, payroll records, public records, and electronic databases to identify irregularities, determine involvement, and develop cases. Responsibilities include gathering and preserving evidence, documenting findings, preparing cases for prosecutorial referral, and maintaining confidential investigative records in accordance with applicable statutes.

The Office of Workers’ Compensation Administration (OWCA) in Louisiana oversees the enforcement and administration of workers’ compensation laws, aiming to support early return-to-work efforts and improve workplace safety. The department manages disputed claims, conducts hearings, reviews medical treatment disputes, and investigates fraud through collaborative efforts like the GAME ON task force.

Ideal Candidate

AN IDEAL CANDIDATE WILL POSSESS THE FOLLOWING COMPETENCIES:

• Communicating Effectively: The ability to convey information, ideas, and emotions using structured communication methods that promote understanding and engagement.
• Following Policies and Procedures: The ability to follow, reinforce, adapt, or develop policies and procedures to maintain compliance with federal and state legal requirements, State Civil Service rules, and organizational policies.
• Thinking Critically: The ability to analyze information objectively, identify connections across sources, and form logical, well-supported conclusions.

Minimum Qualifications

• Three years of experience in accounting, auditing, administrative services, building inspection, real estate appraisal, law enforcement, investigations, or in the issuance or recommendation of medical licenses; OR
• Six years of full-time work experience in any field; OR
• A bachelor's degree.

Experience Substitution

Every 30 semester hours earned from an accredited college or university will be credited as one year of experience towards the six years of full-time work experience in any field. The maximum substitution allowed is 120 semester hours which substitutes for a maximum of four years of experience in any field.

Job Specification

The official job specifications for this role, as defined by the State Civil Service, can be found here.

Job Duties And Other Information

Job Details:

• Monitor timeliness of responses and makes recommendation to supervisor for appropriate penalty assessment based upon research conducted to determine total number of employees and length of time employer has been determined non-compliant utilizing internal and external data sources.
• Analyze evidence and determine if further criminal or civil action is needed.
• Responsible for contacting employers in Louisiana to determine compliance with workers' compensation laws.
• Draft comprehensive investigative reports, for regulatory submission, to document findings and present information to senior management.
• Review Electronic Data Processing (EDP) generated cross-match cases and determine whether further investigation is warranted.
• Issue subpoenas duces tecum when requests for information are ignored.

Position-Specific Details

Location: Baton Rouge, La

Appointment Type: Probational / Job Appointment / Promotional / Detail to Special Duty

Career Progression Group: Compliance Investigator 1, 2, or 3

Contact Information

For further information about this vacancy, contact:

Kedrick Kennedy

[e-mail]

• TDD# 800-259-515

Equal Employment Opportunity

Louisiana Works is an equal employment opportunity employer and SAME agency that serves as a model employer for the recruitment, hiring, and retention of individuals with disabilities. Auxiliary aids and services are available upon request to individuals with disabilities.

Benefits

Insurance Coverage

More information can be found at https://info.groupbenefits.org/

Parental Leave – Up to six weeks paid parental leave

More information can be found at https://www.civilservice.louisiana.gov/Parental-Leave/Default.aspx

Holidays and Leave

• New Year's Day
• Martin Luther King, Jr. Day,
• Mardi Gras,
• Good Friday,
• Memorial Day,
• Independence Day,
• Labor Day,
• Veteran's Day,
• Thanksgiving Day and Christmas Day.
• Additional holidays may be proclaimed by the Governor

State employees earn sick and annual leave which can be accumulated and saved for future use. Your accrual rate increases as your years of service increase.

Retirement

Retirement – State Of Louisiana Employees Are Eligible To Participate In Various Retirement Systems (based On The Type Of Appointment And Agency For Which An Employee Works). These Retirement Systems Provide Retirement Allowances And Other Benefits For State Officers And Employees And Their Beneficiaries. State Retirement Systems May Include (but Are Not Limited To):

• Louisiana State Employees Retirement System (www.lasersonline.org). LASERS has provided this video to give you more detailed information about their system
• Teacher's Retirement System of Louisiana (www.trsl.org),
• Louisiana School Employees Retirement System (www.lsers.net), among others

Assessment Questions

01 Describe your experience conducting investigations and identifying fraud or noncompliance.

02 Describe your experience preparing investigative reports and presenting findings to management, legal counsel, or law enforcement.

03 Communicating Effectively - How well do you share information and ideas in ways that others can understand, relate to, and act on?

• I communicate unclearly, use poor tone, and ignore the audience.
• I share main ideas clearly and adapt to the audience when reminded.
• I communicate clearly, listen actively, and explain complex ideas well.
• I craft messages that connect, inspire, and drive action across audiences.

04 Communicating Effectively - Explain your selection by providing specific examples from your experience. Tip: Use the STAR method (situation, task, action, result) to explain how you have demonstrated this competency. Examples from work, military service, volunteering, education, or other life experiences are all valid.

05 Following Policies and Procedures - How well do you apply rules, policies, and procedures in your work?

• I struggle to follow rules or apply policies correctly, which can lead to confusion or mistakes.
• I follow rules with support and help correct issues, but I sometimes apply policies inconsistently.
• I apply and explain policies accurately, adapt to routine situations, and help improve procedures.
• I guide others in applying policies, prevent compliance issues, and improve procedures based on experience.

06 Following Policies and Procedures - Explain your selection by providing specific examples from your experience. Tip: Use the STAR method (situation, task, action, result) to explain how you have demonstrated this competency. Examples from work, military service, volunteering, education, or other life experiences are all valid.

07 Thinking Critically - How do you analyze information and draw meaningful conclusions from it?

• I miss key details or oversimplify information, and my conclusions may not be based on evidence.
• I try to analyze information, but I may overlook the relevance or credibility of my sources.
• I analyze key information, consider the evidence, and form logical conclusions based on credible sources.
• I uncover deeper insights by connecting different sources, questioning assumptions, and identifying patterns.

08 Thinking Critically - Explain your selection by providing specific examples from your experience. Tip: Use the STAR method (situation, task, action, result) to explain how you have demonstrated this competency. Examples from work, military service, volunteering, education, or other life experiences are all valid.

• Required Question