Healthcare Fraud Investigator - Data-Driven Litigation Support

CGS Federal (Contact Government Services); San Francisco (CA); On-site; USD 65,000 - 90,000; Full time

Job summary

CGS Federal (Contact Government Services) in Nashville, TN seeks a Healthcare Fraud Investigator to provide legal support for a large Government Project. The candidate will analyze data, review financial records, and develop HCF referrals, while coordinating with USAO and client agencies.

Strong analytical skills and US citizenship are required. The role emphasizes proactive questioning, accuracy under pressure, and learning willingness, with opportunities for professional growth within a

Qualifications

• Four year undergraduate degree or higher in criminal justice, finance, project management, or other related field.
• Minimum three (3) years of professional work experience in healthcare, fraud, or related investigative field.
• Proficiency in Microsoft Office applications including Outlook, Word, Excel, PowerPoint, etc.
• Proficiency in analyzing data to assist in providing case support to the Government in civil HCF matters (e.g., Medicare/Medicaid data).
• Strong communication skills with all levels of staff; ability to interact professionally and effectively.
• U.S. Citizenship and ability to obtain adjudication for the requisite background investigation; ability to obtain Public Trust Clearance.

Responsibilities

• Review, sort, and analyze data using computer software programs such as Microsoft Excel.
• Review financial records, complex legal and regulatory documents and summarize contents, and conduct research as needed.
• Prepare spreadsheets of financial transactions (e.g., check spreads).
• Develop HCF case referrals meeting agency and USAO standards for litigation.
• Analyze data for evidence of fraud, waste and abuse.
• Review and evaluate referrals to determine information needed and plan an approach to obtain it.
• Advise HCF attorney(s) regarding merits, weaknesses, and potential defenses; recommend action.
• Assist USAO in developing new referrals and in HCF training for agencies; prepare informational literature.
• Assist conducting witness interviews and preparing written summaries.

Skills

Microsoft Office proficiency

Education

Undergraduate degree or higher in criminal justice/finance/project management or related field

Tools

Microsoft Excel

Job description

CGS Federal (Contact Government Services) in Nashville, TN seeks a Healthcare Fraud Investigator to provide legal support for a large Government Project. The candidate will analyze data, review financial records, and develop HCF referrals, while coordinating with USAO and client agencies.

Strong analytical skills and US citizenship are required. The role emphasizes proactive questioning, accuracy under pressure, and learning willingness, with opportunities for professional growth within a