Remote Medicare Fraud Referral Investigator

Peraton; Florida; Remoto; USD 55.000 - 75.000; Tempo pieno

Descrizione del lavoro

SafeGuard Services (SGS), a Peraton subsidiary, is seeking a Fraud Referral Specialist to evaluate referrals, conduct investigations, and identify potential fraud within Medicare programs. The role involves responding to data requests, analyzing claims data for anomalies, conducting interviews, and reporting findings with a focus on swift follow-up actions.

Telework is available from Florida, and the candidate should be prepared to coordinate with field investigators and data teams as needed.

Competenze

• U.S. citizenship is required.
• Strong interpersonal, analytical, research, and organizational skills are required.
• Excellent verbal and written communications.
• Strong PC knowledge and skills; proficiency with Excel for data sorting/filtering.
• Strong time management and organizational skills required.
• Self-driven and motivated.

Mansioni

• Perform research and draw conclusions.
• 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 available from Florida.

Conoscenze

Interpersonal skills

Analytical

Research

Organizational skills

Communication

PC knowledge

Time management

Self-driven

U.S. citizenship

Formazione

High School Diploma

Bachelor’s degree

Strumenti

Excel

Descrizione del lavoro

SafeGuard Services (SGS), a Peraton subsidiary, is seeking a Fraud Referral Specialist to evaluate referrals, conduct investigations, and identify potential fraud within Medicare programs. The role involves responding to data requests, analyzing claims data for anomalies, conducting interviews, and reporting findings with a focus on swift follow-up actions.

Telework is available from Florida, and the candidate should be prepared to coordinate with field investigators and data teams as needed.