Canton - BWC Fraud Investigator (Healthcare Team) PN -
Canton - BWC Fraud Investigator (Healthcare Team) PN -
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Salary Not Disclosed
1 Vacancy
Job Description
This position is considered a field position and will not be required to report into a physical office on daily basis but based on operational need.
What Our Employees Have to Say:
BWC conducts an internal engagement survey on an annual basis. Some comments from our employees include:
- BWC has been a great place to work as it has provided opportunities for growth that were lacking in my previous place of work.
- I have worked at several state agencies and BWC is the best place to work.
- Best place to work in the state and with a sense of family and support.
- I love the work culture helpfulness and acceptance Ive been embraced with at BWC.
- I continue to be impressed with the career longevity of our employees their level of dedication to service pride in their work and vast experience. It really speaks to our mission and why people join BWC and then retire from BWC.
If you are interested in helping BWC grow please click this link to read more and then come back to this job posting to submit your application!
What Youll Be Doing:
Interview subjects of health care fraud investigations to obtain statements affidavits &/or confessions
Interviews & documents contact with other individuals (e.g. informants witnesses physicians attorneys victims) associated with allegations of health care fraud.
Collects & preserves all evidence to support case findings.
Prepare concise accurate & detailed investigative reports.
Operate a personal computer (e.g. develops & maintains databases creates & maintains spreadsheets enter all investigative activities searches the internet to locate resources) daily.
Conduct covert surveillance and undercover activities to identify fraudulent activity perpetrated by health care providers.
At the State of Ohio we take care of the team that cares for Ohioans. We provide a variety of quality competitive benefits to eligible full-time and part-time employees*. For a list of all the State of Ohio Benefits visit ourTotal Rewards website! Our benefits package includes:
- Medical Coverage
- Free Dental Vision and Basic Life Insurance premiums after completion of eligibility period
- Paid time off including vacation personal sick leave and 11 paid holidays per year
- Childbirth Adoption and Foster Care leave
- Education and Development Opportunities (Employee Development Funds Public Service Loan Forgiveness and more)
- Public Retirement Systems (such as OPERS STRS SERS and HPRS)&Optional Deferred Compensation (Ohio Deferred Compensation)
*Benefits eligibility is dependent on a number of factors. The Agency Contact listed above will be able to provide specific benefits information for this position.
EEO & ADA Statement:
The State of Ohio is an Equal Employment Opportunity Employer and prohibits discrimination and harassment of applicants or employees due to protected classes as defined in applicable federal law state law and any effective executive order.
The Ohio Bureau of Workers Compensation is committed to providing access and reasonable accommodation in its employment opportunities pursuant to the Americans with Disabilities Act and other applicable laws. To request a reasonable accommodation due to disability please contact ADA Coordinator Kathleen Bourke at or by email to:
BWC OCSEA Selection Rights:
This position shall be filled in accordance with the provisions of the OCSEA Collective Bargaining Agreement. BWC bargaining unit members have selection rights before non-bargaining unit members. All other applications will only be considered if an internal bargaining unit applicant is not selected for this position.
Salary Information:
Hourly wage is expected to be paid at step 1 of the pay range associated with the position for candidates who are new employees of the state. Current employees of the state will be placed in the appropriate step based on any applicable union contract and/or requirements of the Ohio Revised Code. Movement to the next step of the pay range (a roughly 4% increase) will occur after six months assuming job performance is acceptable. Thereafter an employee will advance one step in the pay range every year until the highest step of the pay range is reached. There may also be possible cost of living adjustments (COLA) and longevity supplements begin after five (5) years of state service.
Educational Transcripts:
For any educational achievements to be considered during the screening process you must at least attach an unofficial transcript that details the coursework you have completed.
All applicants must submit an Ohio Civil Service Application using the online Ohio Hiring Management System. Paper applications will not be accepted.
Background Check:
Prior to an offer of employment the final applicant will be required to sign a background check authorization form and undergo a criminal background check. Criminal convictions do not necessarily preclude an applicant from consideration for a position.
The State of Ohio is a drug-free workplace which prohibits the use of marijuana (recreational marijuana/non-medical cannabis). Please note this position may be subject to additional restrictions pursuant to the State of Ohio Drug-Free Workplace Policy (HR-39) and as outlined in the posting.
A Little About Us:
With roughly 1500 employees in seven offices across Ohio BWC is the state agency that cares for Ohio workers by promoting a culture of safety at work and at home and ensuring quality medical and pharmacy care is provided to injured workers.
For Ohio employers we provide insurance policies to cover workplace injuries and safety and wellness services to prevent injuries.
Our Culture:
BWC is a dynamic organization that offers career opportunities across many different disciplines. BWC strives to maintain an inclusive workplace. We begin by being an equal opportunity employer. Employees can participate in and lead employee work groups participate in on-line forums and learn about how different perspectives can improve leadership skills.
Our Vision:
To transform BWC into an agile organization driven by customer success.
Our Mission:
To deliver consistently excellent experiences for each BWC customer every day.
Our Core Values:
One Agency Personal Connection Innovative Leadership Relentless Excellence.
Ohio is a Disability Inclusion State and strives to be a model employer of individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services activities programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws.
Completion of associate core program in criminology criminal justice or law enforcement; 18 mos. conducting criminal investigations. (Note: conducting criminal investigations is defined as performing field interviews & interrogation field surveillance field information & evidence gathering techniques while conducting investigations involving violations of criminal law (i.e. special emphasis on theft & fraud cases) as well as researching various administrative laws policies & procedures related to commission of possible criminal offenses); if required to operate state vehicle valid drivers license.
-Or for positions focused on forensic accounting/auditing: Completion of associate core program in forensic accounting/auditing or accounting: 18 mos. performing forensic accounting/auditing duties; if required to operate state vehicle valid drivers license. The final applicant accepted for this position must successfully pass state highway patrol personal background check prior to employment.
-Or equivalent of Minimum Class Qualifications For Employment noted above. Note: Pursuant to Ohio Administrative Code Chapter 4501users of system shall adhere to policies & guidelines published in NCIC operating manual CJIS security policy LEADS operating manual LEADS security policy newsletters & administrative messages from LEADS all of which are either available on ODPS/LEADS intranet or disseminated to LEADS agencies; pursuant to LEADS security policy (revised 05/07/03) state & national fingerprint-based record checks must be conducted within 30 days of initial employment or assignment of all personnel including appropriate IT personnel having access to LEADS or to records storage areas containing CCH/II data; minimum check must include submission of both a State of Ohio BCI& I card & an FBI applicant fingerprint card; both completed applicant fingerprint cards must be submitted by employing agency to State of Ohio Bureau of Criminal Identification & Investigation for processing & forwarding to Federal Bureau of Investigation; record of this check must be kept by employing agency & made available to LEADS upon request; fingerprint card returned by Ohio BCI&I is sufficient documentation. Pursuant to Ohio Administrative Code Chapter 4501 terminal agency shall conduct a complete background investigation of all terminal operators including but not limited to: an applicant fingerprint card submission to BCI&I & FBI an inquiry of state & national arrest & fugitive files; terminal agency is required to notify CTO of any applicants criminal record; existence of a criminal record may result in denial of access.
Job Skills: Investigation
Major Worker Characteristics:
Knowledge of: criminology criminal justice or law enforcement; BWC* state & &/or federal statutes rules regulations & procedures applicable to investigations; evidence gathering & search & seizure; public relations; interviewing; case preparation; LEADS operator rules & regulations*; human relations. Skill in: operation of personal computer database & spreadsheet software; analytical software used in fraud detection*; surveillance equipment (e.g. cameras camcorders mini cameras undercover audio/video recording devices)*.
Ability to: define problems collect data establish facts & draw valid conclusions; gather collate & classify information about data people &/or things; prepare meaningful concise & accurate reports; conduct interviews effectively; assess immediate situation & make split-second decisions; handle sensitive inquiries from & contacts with officials & general public; safely handle irate &/or dangerous citizens; recognize unusual or threatening conditions & take appropriate action; independently deal with many variables & determine specific action during investigative process; comprehend & record figures accurately; add subtract multiply & divide whole numbers; calculate fractions decimals & percentages; understand manuals & verbal instructions technical in nature; use proper research methods in gathering data; work in isolation.
Employment Type
Full-Time
