Fraud Investigator II

Virginia Department of Social Services; Yorktown (VA); On-site; USD 35,000 - 80,000; Full time

Job summary

Virginia Department of Social Services is seeking a Fraud Investigator II to manage investigations, calculate overpayments, and initiate actions across program areas. The role differentiates from supervisory positions by its primary non-supervisory focus.

Qualifications include a high school diploma with relevant experience; preferred 4-year degree in human services or related fields. The position requires strong investigative and analytical skills, plus the ability to work with law enforcement

Qualifications

• High school diploma with related experience in human services or case management and some legal work.
• Experience preferred in a Virginia Local Department of Social Services as a Fraud Investigator.
• Knowledge of investigation techniques, public assistance programs, and legal processes.

Responsibilities

• Receive, evaluate, and track allegations of suspected fraud.
• Conduct inquiries to determine client intent across program areas.
• Determine administrative disqualification or refer to Commonwealth’s Attorney.
• Calculate overpayments and track payments.
• Train others and assist law enforcement for court cases.

Skills

Oral communication

Written communication

Math operations

Overpayment calculations

Court testimony

Training others

Relationship building

Independent work

Data analysis

Documentation

Report writing

Persuasion

Interview data

Time management

Education

High School diploma

Experience in human services

Bachelor’s degree preferred

Tools

Accurint/LexisNexis

IRMS

eDRS

SPIDeR

VaCMS

DMIS

EBT.EPPIC

Data Warehouse

Job description

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)

6. Percentage of Income Payment Program (PIPP)

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.