Fraud Investigator

Office of the Indiana Attorney General; Indianapolis (IN); On-site; USD 55,000 - 75,000; Full time

Job summary

Office of the Indiana Attorney General seeks an Medicaid Fraud Control Unit Investigator to examine provider fraud with emphasis on forensic accounting and white collar crime investigations. Candidates should have experience in forensic accounting or health care fraud investigations and will gather records, interview witnesses, and prepare court-ready reports.

Responsibilities include court case preparation, subpoenas, and travel across Indiana to collect documents and testify as needed.

Qualifications

• Four-year degree in Accounting or related field or four years law enforcement investigative experience.
• Working knowledge of state and federal laws and court procedures.
• Ability to write detailed, accurate and legible reports.
• Ability to organize, set priorities, work independently.
• Health care fraud investigating experience preferred.

Responsibilities

• Order documentation such as from fiscal intermediaries and obtain bank, medical, patient, and business records.
• Research documentation to identify patterns of billing irregularities and develop schedules of provider billing activities.
• Locate and interview witnesses, suspects and possible experts; testify in proceedings.
• Prepare investigation reports for prosecutors and assist in case preparation for court.
• Take part in investigator training and perform other duties as required.
• Travel as needed, often totaling substantial miles monthly, to various offices and sites.

Skills

Forensic accounting

White collar investigations

Education

Bachelor's degree in Accounting or related field

Four years law enforcement investigative experience

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.

• 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.

*Pay commensurate with experience