Healthcare Fraud Investigator - Litigation Support

CGS Federal (Contact Government Services); Boston (MA); On-site; USD 70,000 - 100,000; 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 role demands initiative, meticulous work under pressure, and a commitment to learning and applying knowledge to support litigation.

A four-year degree and three years of related investigative experience are required. Responsibilities include reviewing data in Excel, analyzing financial records and regulatory documents, developing HCF

Qualifications

• Four (4) 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 other related investigative field of work.
• Proficiency in Microsoft Office applications including Outlook, Word, Excel, PowerPoint, etc
• Proficiency in analyzing data that would assist in providing specific case support to the Government in civil HCF matters (E.g., Medicare data, Medicaid data)
• Communication skills: Ability to interact professionally and effectively with all levels of staff and attorneys
• U.S. Citizenship and ability to obtain adjudication for the requisite background investigation
• Must be a US Citizen; Ability to obtain a favorable 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
• Develop HCF case referrals including, but not limited to:
• Ensure that HCF referrals meet agency and USAO standards for litigation
• Analyze data for evidence of fraud, waste and abuse
• Review and evaluate referrals to determine the need for additional information and evidence, and plan comprehensive approach to obtain this information and evidence
• Advise the HCF attorney(s) regarding the merits and weaknesses of HCF referrals and recommend for or against commencement of judicial proceedings
• Assist the USAO develop new referrals by ensuring relationships with client agencies and assisting in HCF training
• Assist conducting witness interviews and preparing written summaries

Skills

Attention to detail

Communication skills

Analytical thinking

Team collaboration

Education

Four-year undergraduate degree or higher in criminal justice, finance, project management, or related field

Tools

Microsoft Excel

Microsoft Word

Microsoft PowerPoint

Outlook

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 role demands initiative, meticulous work under pressure, and a commitment to learning and applying knowledge to support litigation.

A four-year degree and three years of related investigative experience are required. Responsibilities include reviewing data in Excel, analyzing financial records and regulatory documents, developing HCF