Remote Medicare Fraud Investigator

Peraton; Reston (VA); Remote; USD 66,000 - 106,000; Full time

Job summary

Peraton’s SafeGuard Services (SGS) seeks a Fraud Investigator to join a team that performs data analysis, investigation and medical review to detect fraud in Medicare programs. This role involves leading high level investigations, developing cases for action and coordinating with government and health entities.

The investigator will analyze evidence, interview witnesses, prepare reports, and may testify in court. Telework is possible with a strong overnight travel readiness as required.

Qualifications

• 5 years with BS/BA or 9 years with a HS Diploma/equivalent.
• 5–6 years investigative experience.
• Strong investigative skills and ability to communicate and organize.
• US Citizenship is required.

Responsibilities

• Perform high level complex investigations of medical professional service providers and develop cases for future action.
• Collaborate with internal resources and external agencies to develop cases and corrective actions.
• Prepare complex investigative reports applying regulations or rules to the programs affected.
• Appear in court to testify to work findings when required.
• Maintain confidentiality and understand health privacy laws and regulations.

Skills

Investigative skills

Communication skills

Organizational skills

PC skills

Education

BS/BA degree

HS diploma/equivalent

Job description

Peraton’s SafeGuard Services (SGS) seeks a Fraud Investigator to join a team that performs data analysis, investigation and medical review to detect fraud in Medicare programs. This role involves leading high level investigations, developing cases for action and coordinating with government and health entities.

The investigator will analyze evidence, interview witnesses, prepare reports, and may testify in court. Telework is possible with a strong overnight travel readiness as required.