Remote Fraud Referral Specialist

Peraton; United States; Remote; USD 51,000 - 82,000; Full time

Benefits offered by this job

Medical

Dental

Vision

Life Insurance

Health Savings Account

Disability Insurance

Employee Assistance Program

Parental Leave

401(k)

PTO

Company Holidays

Job summary

Peraton is seeking a Fraud Referral Specialist for SafeGuard Services (SGS). The role involves using diverse tools to evaluate referrals and develop investigations to identify potential fraud within Medicare and Medicaid programs.

Telework is available from EST, CST, MST time zones, with duties spanning referrals, data requests, interviews, and reporting findings. You will handle case files, document steps, and coordinate with field teams or data teams for follow-up actions.

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
• Investigative or analytical experience
• Strong interpersonal, analytical, research, and organizational skills are required
• Excellent verbal and written communications

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 available from EST, CST, MST time Zones.

Skills

Investigative experience

Analytical skills

Interpersonal skills

Verbal and written communication

Excel data analysis

Time management

US citizenship

Education

Bachelor's degree or equivalent

High School diploma or equivalent

Job description

Peraton is seeking a Fraud Referral Specialist for SafeGuard Services (SGS). The role involves using diverse tools to evaluate referrals and develop investigations to identify potential fraud within Medicare and Medicaid programs.

Telework is available from EST, CST, MST time zones, with duties spanning referrals, data requests, interviews, and reporting findings. You will handle case files, document steps, and coordinate with field teams or data teams for follow-up actions.