Healthcare Fraud Investigator - Pensacola, United States - 1st Choice, LLC

Description

Job Description

Job Description

We are seeking a highly skilled and motivated investigator to support a prestigious federal agency located in Pensacola, Florida, with complex investigations into criminal and civil healthcare fraud matters. This position offers the unique opportunity to contribute to critical investigations that protect public resources and ensure the integrity of our healthcare system. You will work alongside a dedicated team of professionals at this agency to investigate healthcare fraud within their jurisdiction.

Location: Pensacola, Florida
Work Schedule: This is a full-time position (40 hours/week), typically during standard business hours (Monday-Friday, 8 AM to 5 PM).

Key Responsibilities:
A. Plan and conduct investigations of a complex and difficult nature; perform quantitative, qualitative, or other analysis of relevant facts; and prepare the results to
support the mission of the client. Investigations may be conducted solely by the client, or more typically, in conjunction with federal and state agencies responsible for programs
supported by federal funding. These agencies may include, but are not limited to, the United States Department of Health and Human Services; the Federal Bureau of Investigation; the Defense Criminal Investigative Service; and the Drug Enforcement Administration.

B. Research background information using various databases and sources; identifying subjects to investigate and developing leads; conducting interviews; collecting and processing evidence; preparing reports, charts, and exhibits; and helping build financial investigations regarding the subjects and their conduct. To that end, the investigator would utilize analytical skills in order to do the following: identify and obtain financial records; identify and obtain health care provider data; analyze health care, business, and financial records; and conduct interviews of witnesses and prepare reports of interviews.

C. Develop an understanding of all applicable federal, state, or local law to the extent necessary to make sound decisions on the direction and scope of investigations. Determine proof required to affix responsibility for violations, and develop methods for obtaining, preserving, and presenting evidence effectively.

D. Work with the assigned Assistant United States Attorneys (AUSAs), Paralegal Specialists and supervisory attorneys to determine applicable statutory and regulatory law
and identify possible violations.

E. Perform a variety of ancillary services in direct support of assigned cases and matters. i. Use electronic databases to identify assets, documents, and other physical evidence. ii. Prepare interim and final reports on progress of investigations for use by AUSAs and supervisory attorneys. Reports shall include significant findings and conclusions, recommendations for additional investigative actions, and candid assessments of strengths and weaknesses of witnesses, documentary evidence, and other aspects of case. iii. Arrange for secure storage, preservation, organization, and indexing of voluminous documentary evidence. iv. Assist in compilation and analysis of documents and physical evidence, and creation of charts, graphs, videotapes, and other audio-visual materials
for use in hearings and at trial. Assist in developing the most efficient method for conducting investigations and identify any resources that may be needed.

F. Initiate contacts with federal, state, and local officials, and other organizations and individuals related to subject of investigation for the purpose of gathering facts, obtaining statements, learning sequences of events, obtaining explanations, and otherwise advancing investigative objectives. Examine books, ledgers, payroll records, cost reports, billing statements, invoices, correspondence, computer data and other records pertaining to the transactions, events, or allegations under investigation. Establish and verify relationships among all facts and evidence obtained or presented to confirm authenticity of documents, corroborate witness statements, and otherwise build proof necessary to successful case resolution.

Travel Requirements:

• This position requires travel to locations within the Client locations: Tallahassee, Pensacola, and Gainesville FL, as well as occasional statewide travel.
• You may also be required to attend training at the National Advocacy Center located in Columbia, South Carolina.
• Travel expenses will be reimbursed in accordance with standard government guidelines.

Required Skills and Qualifications:

• Minimum of 4 years of experience conducting complex investigations, preferably in a law enforcement context and federal setting.
• Strong knowledge of legal and law enforcement terms and procedures.
• Excellent analytical skills and the ability to synthesize large amounts of data.
• Proficient in Microsoft Office Suite, including Word, Excel, and database management.
• Exceptional written and verbal communication skills.

Preferred Qualifications

• Bachelor's degree.
• Experience analyzing medical records and understanding medical billing procedures.
• Proven ability to interview witnesses effectively.

Additional Requirements:

• Must be a U.S. Citizen.
• Ability to obtain and maintain a minimum 7- or 10-year background investigation clearance.
• Valid driver's license.

1st Choice is a professional management consulting firm with more than two decades of experience delivering innovative consulting, technology, and staffing solutions to federal and commercial organizations throughout the United States. We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law

Company Description1st Choice is a professional management consulting firm with more than two decades of experience delivering innovative consulting, technology, and staffing solutions to federal and commercial organizations throughout the United States.

At 1st Choice we embrace diversity of humanity and all it brings to creating an innovative environment. 1st Choice exhibits a compelling workplace through its ethically driven team and diverse academic backgrounds the staff delivers to the organization. We take pride in hiring staff that offers world-class service to support government agencies, corporations, and non-profit organizations nationwide.

Company Description

1st Choice is a professional management consulting firm with more than two decades of experience delivering innovative consulting, technology, and staffing solutions to federal and commercial organizations throughout the United States.\r
\r
At 1st Choice we embrace diversity of humanity and all it brings to creating an innovative environment. 1st Choice exhibits a compelling workplace through its ethically driven team and diverse academic backgrounds the staff delivers to the organization. We take pride in hiring staff that offers world-class service to support government agencies, corporations, and non-profit organizations nationwide.