Fraud Investigator

The work we do matters!

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Location:

Hiring Rate:

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Job Description:

The Fraud Investigator:

• Conducts audits of files client records and computer-generated printouts to identify potential intentional program violations by clients or staff. Reviews case files to determine if files are complete accurate and meet existing guidelines. Writes reports of investigative findings.

• Interviews service providers employers clients and third parties to collect information about the services and assistance provided to obtain evidence of fraud and abuse to verify information and to inform them of the applicable aspects of the law.

• Determines whether or not there was intent by a client to defraud the agency and if the client should be referred for criminal prosecution and/or an administrative hearing.

• Represents the agency at Intentional Program Violation (IPV) hearings and criminal court proceedings to present evidence and explain investigation and findings. Questions witnesses and presents summary of the States position at IPV hearings. Consults with agency employees and witnesses to prepare them for administrative and court appearances.

• Makes referrals for recoupment of overpayments when collection activities are warranted and criminal prosecution is not possible. Negotiates repayment agreements for overpayments.

• Acts as a resource to the public and DHHS staff receives referrals from the public DHHS staff government agencies other state agencies law enforcement officials school officials etc.

Hiring Rate of Position: $21.672 per hour Non-Exempt
Work Schedule: Monday Friday 8:00 AM 5:00 PM
Dress Attire: Business Casual

Location: Scottsbluff

Driving is required.

Requirements/Qualifications

Minimum Qualifications:Post high school coursework/training in: criminal justice law social work or criminal investigative methods ORExperience in a social service agency with responsibility for eligibility determination in a variety of program areas ORExperience performing investigation auditing research or information search activities medical or service provider billing claims adjustment review or processing service or payment authorization.

Preferred Qualifications:

• Prior law enforcement or criminal investigation experience.

• Emphasis on experience involving completing investigations and investigative report writing.

Other: Valid drivers license or the ability to provide independent authorized transportation.

Please indicate on your resume in your application or cover letter the Preferred Qualificationsyou meet. List what prior law enforcement or criminal investigation experience you have; as well; as experience completing investigations and investigative report writing.

Knowledge Skills and Abilities:

Knowledge of: principles practices and techniques of interviewing to gather information; public assistance programs; techniques of case management.

Ability to: obtain record and document information; learn and apply agency rules and procedures regarding fraud and abuse investigations; learn interpret and apply State and Federal rules and regulations regarding abuse of social services programs; learn and operate social service computer programs and functions; interact with clients employees and criminal justice authorities to conduct investigations and establish working relationships; communicate with others to relay and gather information; make decisions and take action in dealing with problems and situations within established guidelines; conduct and control interviews to obtain information from cooperative and uncooperative individuals; solve arithmetic problems; speak before groups to present technical information; prepare accurate and concise written reports; explain processes and procedures.

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The State of Nebraska values our teammates as well as a supportive environment that strives to promote diversity inclusion and belonging. We recruit hire train and promote in all job classifications and at all levels without regard to race color religion sex. age national origin disability marital status or genetics.