Fraud Investigator

Office of the Indiana Attorney General; Hobart (IN); On-site; USD 55,000 - 85,000; Full time

Job summary

The Office of the Indiana Attorney General is seeking a Medicaid Fraud Control Unit Investigator in Hobart, Indiana. You will investigate provider fraud under the supervision of the Supervising Deputy Attorney General, obtain bank/medical records, interview witnesses, and collaborate with prosecutors to prepare cases for court.

Preferred candidates have forensic accounting or white-collar investigation experience, strong report writing, and knowledge of healthcare billing practices.

Qualifications

• A four-year degree in Accounting or related fields, or four years law enforcement investigative experience is preferred.
• Working knowledge of state and federal laws and court proceedings.
• Ability to write detailed, accurate and legible reports.
• Ability to organize and set priorities, work independently, stay on task.

Responsibilities

• Investigate provider fraud under direction of Supervising Deputy Attorney General.
• Obtain documents such as bank records, medical records, patient files and other evidence for judicial proceedings.
• Research billing patterns and develop schedules of provider billing activities.
• Locate, interview witnesses, suspects and possible expert witnesses; conduct surveillance.
• Prepare investigation reports and present findings to prosecutors; assist in preparing the case for court.
• Travel as needed, including long trips for investigations and document collection.
• Possess a valid Indiana driver’s license and travel to various locations within Indiana.

Skills

Forensic accounting

White-collar investigations

Investigative reporting

Documentation

Education

Accounting degree or related field

Tools

Microsoft Excel

Job description

Investigators are assigned cases under the direction of the Supervising Deputy Attorney General. The Indiana Medicaid Fraud Control Unit Investigator shall investigate provider fraud. The preferred Investigator candidate shall have experience in forensic accounting or white collar crime investigations. This position is located in Hobart Indiana.

• Order various documentation from the fiscal intermediary;
• Obtain other documents such as bank records, medical records, patient files, business records, and other records to be used as evidence in judicial proceedings;
• Research the documentation for patterns of billing an illegal activity, and develop schedules of provider billing activities;
• Locate, conduct surveillance and interview witnesses, suspects and possible expert witnesses;
• Collaborate with other investigators on investigations;
• Regularly participate in multi-disciplinary team meetings;
• Prepare written and recorded statements and evaluate testimony for credibility;
• Conduct undercover operations;
• Prepare comprehensive investigation reports for presentation to a Deputy Attorney General or state or federal prosecutor for criminal referrals;
• Assist the Deputy Attorney General or state or federal prosecutor in preparing the case for court;
• Locate and serve subpoenas on witnesses and suspects;
• Testify in criminal and administrative proceedings;
• Draft clear and concise Probable Cause Affidavits;
• Complete any necessary component of the Indiana Law Enforcement Academy;
• Participate in investigator training and perform other work as required.
• Such travel as the assignment of duties may necessitate, usually consisting of frequent trips totaling more than 1000 miles per month, for the following purposes:
  • Travel to state offices, jails, police departments, sheriff’s departments, courthouses, offices of businesses contracting with healthcare providers, and such other locations as may be necessary for the purpose of obtaining documents, statements, and other evidence necessary to an investigation.
  • Travel to surveillance locations and conducting surveillance from a vehicle for extended periods of time in all types of weather and at all times of day or night.
  • Travel to and assist in serving search warrants and seizing evidence at such times as is best for the purposes of the investigation, including times beyond normal duty hours, and to transport to such sites the supplies and tools, including storage boxes and document scanners, as may be required.
  • Travel directly from home to the office of a healthcare provider under investigation, to an office of the Medicaid Fraud Control Unit other than the assigned duty station, or to other locations required by an investigation, as may be necessary to the efficient and effective completion of an investigation.

• A four-year degree in Accounting or related fields, or four years law enforcement investigative experience is preferred but not required.
• Working knowledge of state and federal laws and court proceedings.
• Working knowledge of the laws of search and seizure, standards of identification, collection and preservation of evidence.
• Ability to write detailed, accurate and legible reports.
• Ability to organize and set priorities, work independently, stay on task.
• Preferred candidate will have experience in law enforcement and health care industry, with emphasis on health care fraud investigating experience.
• Working knowledge of health care operations, billing, coding and documentation guidelines is preferred but not required.

Work Environment

• Ability to work inside and outside of an office atmosphere.
• Ability to drive an automobile to locations inside and outside the state of Indiana for work and training purposes.
• Schedule varies depending upon the type of investigation.

Essential Functions

• Valid Indiana driver’s license.
• Review and analyze documents containing writings in the English language.
• Accurately compile and calculate numeric information in applications such as, but not limited to, Microsoft Excel.