Fraud Investigator

Eau Claire County; Eau Claire (WI); Remote; USD 55,000 - 75,000; Full time

Job summary

Eau Claire County seeks a Fraud Investigator to examine public assistance fraud, conduct investigations, and report activities in compliance with laws. The role involves field investigations, training, and collaboration with agencies within the Great Rivers Consortium.

The position requires an associate degree in criminal justice or related field and two years of investigative experience, with strong record-keeping and confidentiality. Remote work with travel within the region is expected.

Qualifications

• Associate degree in criminal justice, human services, or related field.
• Two years of investigations experience with interviewing, evidence gathering, and reporting.
• Proficiency with computers and electronic documentation systems.
• Criminal and caregiver background checks required; valid driver's license.
• Remote work with regional travel within the ten-county consortium.

Responsibilities

• Investigate public assistance fraud; document and report findings.
• Conduct fraud prevention training and monitor performance measures.
• Maintain confidential records and prepare reports for prosecutors.
• Provide testimony in court or administrative hearings when needed.
• Establish working relationships with local/state agencies and the public.

Skills

Leadership

Investigative methods

Record keeping

Testimony in court

Interviews

Confidentiality

Collaboration

Education

Associate degree in criminal justice or related field

Experience in investigations

Tools

CARES

KIDS

CSAW

BRITS

ebtEDGE

Job description

The Fraud Investigator examines public assistance fraud, conducts fraud prevention activities, and performs benefit recovery activities for overpayment claims for the multi-county Great Rivers Consortium (GRC). This position documents and reports activities in compliance with laws and regulations.

• Demonstrates effective motivational leadership techniquesto act as investigator to the Great Rivers Income Maintenance Consortium; transfers expertise in investigative techniques and methods to provide direction for the course of field investigations; maintains electronic and written files on the progress and status of field investigations in adherence to legal requirements; provides fraud prevention training for consortium staff in order to make full use of individual capabilities and to meet changing system demands; monitors achievement of outcome-based performance measures to maintain quality of service.
• Illustrates knowledge of current laws and regulations pertaining to economic support programs and eligibility factors to examine and report potential fraud, waste, and abuse as well as complaints and concerns regarding publicly funded and supported services; receives, records, and assesses the legitimacy of complaints and referrals of suspected fraud for economic support programs;conducts intensive investigative interviewsto determine whether or not fraud was intentionally committed;obtains and verifies third-party information; collaborates with various agencies and support services; maintains strict confidentiality on all contacts made and information gathered.
• Prepares and maintains detailed and concise records and reports in compliance with legal record keeping and reporting requirements; compiles information and prepares written reports on information gathered for the District Attorney's office; records and documents all Front-End Verification (FEV) and fraud investigation referrals and actions taken; determines, conducts, documents, and reports appropriate verification actions.
• Provideseffective and credibletestimonyin court or administrative hearings regarding clients’ allegedly fraudulent activities, investigations, and findings.
• Conducts special case audits on targeted areas, particularly error prone cases; exercises judgement to determine outcome and provide recommendations based on results.
• Establishes and maintains professional working relationships with local and state agencies, law enforcement, employers, and the general public.
• Performs other related duties as required or assigned.

• Associate degree in criminal justice, human services, or a related field; or an equivalent combination of education, training, and relevant investigative experience.
• Two (2) years of experience conducting investigations, including investigative interviewing, gathering and evaluating evidence or information, and preparing investigative reports. Experience may include criminal, civil, administrative, fraud, compliance, public assistance, or other related investigations.
• Proficiency using computers and electronic systems for documentation, research, communication, and report preparation.
• Appointment will be conditional upon successful completion of criminal and caregiver background checks.
• Must maintain a valid driver’s license and automobile liability insurance meeting or exceeding Wisconsin’s minimum coverage requirements, with proof of insurance provided upon hire and maintained throughout employment.
• This position will work remotely travel within the ten-county consortium region.
• An ergonomically correct and confidential workspace, at own expense, is required for this position when working remotely.
• Employees must provide high speed internet access at own expense when working remotely.
• Must be a Wisconsin resident.

• Experience working withClient Assistance for Reemployment and Economic Support (CARES), Forward Health, State of Wisconsin Kids Information Data System (KIDS), Child Care Statewide Administration on the Web (CSAW), Benefit Recovery Investigation Tracking System (BRITS) and/or ebtEDGE.
• Experience interpreting and applying public assistance policies and procedures related to Medicaid, FoodShare, and Child Care benefits.