Fraud Investigator

Office of the Indiana Attorney General; Mettawa (IL); On-site; USD 50,000 - 80,000; Full time

Job summary

Join a dedicated team committed to serving the people of Indiana as an Investigator with the Medicaid Fraud Control Unit. This role involves investigating provider fraud, conducting surveillance, and preparing detailed reports for legal proceedings. Ideal candidates will possess a strong background in law enforcement or forensic accounting, with a passion for upholding justice and ensuring the integrity of healthcare services. If you are ready to make a significant impact in the community and work alongside a team of professionals dedicated to excellence, this position is for you.

Qualifications

• Experience in investigations or audits, particularly in healthcare fraud.
• Strong analytical and investigative skills to handle complex cases.

Responsibilities

• Investigate provider fraud from the Indiana Medicaid Program.
• Prepare comprehensive investigation reports for court presentations.

Skills

Investigative Skills

Forensic Accounting

Surveillance Techniques

Interviewing Skills

Analytical Skills

Education

Bachelor's Degree

Law Enforcement Experience

Tools

Microsoft Word

Microsoft Excel

Job description

For more than 165 years, the Office of the Indiana Attorney General (OAG) has been committed to serving the best interests of the State and all Hoosiers. OAG employees have earned an outstanding reputation for meeting the highest professional standards, providing great service, and demonstrating courageous leadership and commitment to excellence to the people of Indiana. If you share our determination to make Indiana a better place to live and work, we invite you to join over 400 of the very best employees and seek a career with the Office of the Indiana Attorney General.

Description

Investigators are assigned cases under the direction of the Fraud Team Supervisor. The Indiana Medicaid Fraud Control Unit Investigator shall investigate provider fraud from the Indiana Medicaid Program. The preferred Investigator candidate shall have experience in investigations or audits involving health care providers, forensic accounting, or white-collar crime investigations. The Investigator works independently or as part of a team. The position can have a reporting station of Indianapolis, Evansville, or Jeffersonville.

Examples of Duties

1. Obtain various documentation from the fiscal intermediary, including bank records, medical records, patient files, business records, and other evidence for judicial proceedings.
2. Research documentation for patterns of billing and illegal activity, and develop schedules of provider billing activities.
3. Locate, conduct surveillance, and interview witnesses and suspects.
4. Identify and interview expert witnesses; evaluate statements for credibility.
5. Conduct undercover operations.
6. Prepare comprehensive investigation reports for presentation to prosecutors and assist in case preparation for court.
7. Locate and serve subpoenas; testify in criminal and administrative proceedings.
8. Complete required training at the Indiana Law Enforcement Academy and participate in investigator training.
9. Analyze Medicaid claims and medical records; conduct case-related research involving diseases and procedures.
10. Access relevant medical and coding information online.
11. Conduct on-site and off-site audits of Medicaid providers; perform financial analyses including tracing illicit funds.
12. Maintain proper procedures for evidence handling and chain of custody.
13. Maintain internal control documents, including mileage, time tracking, and travel reports.
14. Travel as necessary to conduct investigations, serve warrants, and provide testimony, including travel from home to various locations and during emergencies.

Typical Qualifications

• A four-year degree from an accredited college or university or a minimum of four years law enforcement experience.
• Computer skills, including working knowledge of Microsoft Word and Excel.
• Preferred experience in law enforcement and healthcare industry, especially in health care fraud investigations.

Supplemental Information

• Valid Indiana Driver’s License.
• Ability to review and analyze documents in English and accurately compile and calculate numeric information.

The Office of the Indiana Attorney General is an Equal Opportunity Employer.