Remote Fraud Investigation & Referral Specialist

Peraton; Reston (VA); Remote; USD 51,000 - 82,000; Full time

Job summary

Peraton in Reston, Virginia is seeking a Fraud Referral Specialist to join the SafeGuard Services (SGS) team. The role involves evaluating referrals, conducting investigations, and developing case files with thorough documentation for potential regulatory action within Medicare programs.

You will present findings, coordinate with field investigators and data teams, and educate providers and stakeholder groups on safeguard matters. Telework from EST, CST, or MST zones is available, and U.S.

Qualifications

• 2 years with a Bachelor's or 6 years with a HS diploma/equivalent
• At least 2 years of prior experience evaluating complaints or referrals required
• Investigative or analytical experience
• Strong interpersonal, analytical, research, and organizational skills are required
• Excellent verbal and written communications
• Strong PC knowledge and skills
• Strong use of Excel and being able to sort and filter data
• Strong time management and organizational skills required
• Self-driven and motivated
• U.S. citizenship required

Responsibilities

• Perform research and draw conclusions
• Evaluate complaints and referrals for further investigation
• Present issues of concern, citing regulatory violations, alleging schemes or scams to defraud the Government
• Organize a case file, accurately and thoroughly document all steps taken
• Conduct background investigation on providers within the Medicare program
• Compose correspondence, reports, and referral summary letters
• Educate providers, provider associations, law enforcement, other contractors, and beneficiary advocacy groups on program safeguard matters
• Telework position avaialble from EST, CST, MST time Zones.

Skills

Investigative experience

Analytical skills

Interpersonal skills

Verbal and written communication

Excel proficiency

Time management

U.S. citizenship

Education

Bachelor's degree

High School diploma or equivalent

Job description

Peraton in Reston, Virginia is seeking a Fraud Referral Specialist to join the SafeGuard Services (SGS) team. The role involves evaluating referrals, conducting investigations, and developing case files with thorough documentation for potential regulatory action within Medicare programs.

You will present findings, coordinate with field investigators and data teams, and educate providers and stakeholder groups on safeguard matters. Telework from EST, CST, or MST zones is available, and U.S.