Fraud Investigator II

L-199-York/Poquoson Social Services; Virginia (MN); On-site; USD 35,000 - 80,000; Full time

Job summary

The Fraud Investigator II role at L-199-York/Poquoson Social Services is the full performance level for investigating fraud, calculating overpayments, and initiating Administrative or Court Actions on all Intentional Program Violations.

This position may also train staff, work with law enforcement, prepare reports, track overpayments, and participate in shelter operations during disasters as needed; a strong knowledge of program policies and legal procedures is essential.

Qualifications

• High school diploma with related human services or legal investigation experience.
• Experience in fraud investigation and ability to testify in court.
• Knowledge of welfare programs and applicable laws.

Responsibilities

• Receives, evaluates and tracks allegations of suspected fraud.
• Conducts inquiries and investigations to determine intent or no intent.
• Calculates overpayments and oversees collections.
• Trains staff in fraud prevention/detection and provides guidance.
• Works with law enforcement to prepare cases for trial and testifies as needed.
• Prepares reports and reviews new policy procedures.
• Maintains fraud tracking systems and initiates collection actions.

Skills

Investigation techniques

Court testimony

Data analysis

Communication skills

Training others

Attention to detail

Education

High School diploma + related experience

Bachelor’s degree in human services or related field

Tools

Accurint/LexisNexis

IRMS

eDRS

SPIDeR

VaCMS

DMIS

EBT/EPPIC

Data Warehouse

Job description

Full Time or Part Time: Full Time

Title Description-

The Fraud Investigator II is the full performance level for employees that are responsible for investigating fraud, calculating overpayments, initiating Administrative or Court Action on all Intentional Program Violations, establishing overpayment and overseeing collections. The Fraud Investigator II is distinguished from the Fraud Investigator Supervisor in that the supervisor spends a majority of time in supervisory activities such as handling personnel issues, problems, and evaluating the work of others.

Hiring Range:$35,138-80,000

General Work Tasks (Illustrative Only) –

• Receives, evaluates and tracks allegations of suspected fraud;
• Conducts an inquiry and investigation into the allegation in an effort to determine intent or no intent on the part of the client in all program areas;
• Determines an Administrative Disqualification or refers to the Commonwealth's Attorney Office;
• Calculates overpayments when the overpayment is discovered through a fraud investigation;
• Trains other staff in fraud prevention and detection and may provide guidance;
• Works with law enforcement to prepare cases for trial; Testifies in court, as needed;
• Prepares reports;
• Reviews all new policy and procedures;
• Maintains Fraud Free database tracking system; and
• Initiates collection actions to recover overpayments.

Knowledge, Skills, and Abilities: Knowledge-

Working knowledge of: investigative techniques; public assistance programs; legal proceedings; collection methods; self-defense; public assistance program policies and regulations; terminology and related professional languages used within the department as such pertains to work responsibilities; applicable laws, codes, policies and procedures, including civil and court procedures; basic human behavior; and social problems and resources.

Skills-

Skill in operating a personal computer and the associated office and agency software.

Abilities-

Demonstrated ability to: communicate effectively both orally and in writing; perform addition, subtraction, multiplication, and division; calculate overpayments and track payments; testify in court proceedings; train others; establish and maintain effective working relationships with clients, associates, law enforcement, other agencies and others; work independently; analyze data, recognize gaps and collect information; draw legal and supportable conclusions; prepare reports; apply principles of persuasion and/or influence; document data from interviews, forms, and documents; and organize own work schedule.

Minimum Qualifications: Education and Experience-

High School diploma supplemented with work experience and/or training involving human services program eligibility or case management work and some legal work, which includes court involvement, researching criminal citations and investigative techniques and testimony OR any equivalent combination of training and experience which provides the required knowledge, skills and abilities.

Preferred Qualifications:

• Desired Candidates will possess the following qualifications/experience:
• Bachelor’s degree in human service, or a related field.
• Experience working in a Virginia Local Department of Social Services within the last year as a Fraud Investigator.

Minimum of two (2) years working knowledge and experience in one or more of the following Benefit Programs...

1. Temporary Assistance for Needy Families (TANF)

2. Supplemental Nutritional Assistance Programs (SNAP)

3. Medical Assistance (MA)

4. Energy Assistance (EAP)

5. Child Care (CC)

Experience utilizing the following computer systems...

1. Accurint/LexisNexis

2. Integrated Revenue Management System (IRMS- State Tax Intercept)

3. Electronic Disqualified Recipient System- USDA (eDRS)

4. System Partnering in a Demographic Repository (SPIDeR)

5. Virginia Case Management System (VaCMS)

6. Document Management Imagining System (DMIS)

7. 3. Electronic Benefit System (-EBT.EPPIC)

8. Data Warehouse

Special Requirements:

Applicants must have a valid Virginia driver’s license without restrictions and the driving record must meet agency standards on or before the hire date

Applicants must also meet a level of insurability set by the agency.

Responsible for shelter duty during times of disaster.

Applicants may be subject to a Criminal History Background search, Central Registry search,DMV/driving record check, and/or pre-employment drug screen. The investigation may include: fingerprint checks (State Police,FBI), local agency checks, employment verification and references, verification of education (relevant to employment), credit checks (relevant to employment) and other checks requested by the hiring authority. This position is covered under Code of Virginia §63.2-1601.1 or §63.2-1720 requiring the finalist candidate to submit to fingerprinting and provide personal descriptive information for a criminal history record check through the Central Criminal Records Exchange and a search of the Central Registry. All offers of employment are contingent upon satisfactory results of the required checks and screenings. Employee must be willing to work in the community emergency shelter in the event of a natural disaster or emergency.