Criminal Investigator - Medicaid Fraud Division

Summary

Criminal Investigator - Medicaid Fraud DivisionExplore a world of opportunity with the State of Georgia! Georgia State Government is a large enterprise, composed of various agencies and entities with a common goal to improve the lives of Georgia's more than 10 million citizens! Join Team Georgia and impact lives everyday while receiving a robust benefits package designed for every stage of your career!The mission of the Department of Law is to serve the citizens of the State of Georgia by providing legal representation of the highest quality to the agencies, officers and employees of state government and by honorably and vigorously carrying out the constitutional and statutory responsibilities of the Attorney General. The position filled through this announcement will serve in the Investigations section of our Medicaid Fraud Division.Duties & Responsibilities:Investigators conduct health care fraud investigations.Assists criminal justice personnel, including, but not limited to, Analysts, Auditors, and Prosecutors in conducting on-site health care fraud and patient abuse investigations.Develops necessary knowledge and skills for using computer software programs in unit investigations.Maintains and applies professional knowledge of current trends and developments related to work unit assignments.Positions require current proof of POST Certification.Responds to assignments and requests for assistance in health care fraud and patient abuse investigations in a timely manner.Assists in executing and planning on-site search warrants to obtain evidence of health care fraud and patient abuse.Will be issued a firearm and/or less lethal equipment (e.g. pepper spray).Assists in preparing charts, schedules, and presentations for the prosecution of health care fraud cases.Follows appropriate laws, guidelines, and policies in maintaining the chain of custody for evidence.Collects, reviews, and evaluates the necessary documents to identify and investigate health care fraud and patient abuse, including medical records, health care providers' billing records, and records.Assists in developing databases to analyze appropriate medical data. Enters data into databases and analyzes the data for evidence.Assists in conducting source and expenditure analyses and cash flow analyses of suspects in health care fraud investigations and patient abuse investigations.Assists in searching public records, governmental databases, and commercial databases for evidence of health care fraud and patient abuse allegations.Assists the appropriate parties in identifying potential assets subject to seizure due to health care provider fraud.Utilizes computers and the appropriate software to conduct health care fraud and patient abuse investigations.Demonstrates a basic knowledge of computer software in creating databases, spreadsheets, graphs, and presentations.Demonstrates the appropriate computer skills to conduct health care fraud investigations.Prepares appropriate reports in a timely, thorough, and accurate manner.Presents courtroom testimony utilizing proper courtroom demeanor and assists prosecutors in coordinating pre-trial activities.Maintains supplies, reports, equipment, and relationships with other agencies according to established Unit requirements.Maintains professional knowledge of current trends and developments in the field and applies pertinent new knowledge to the performance of other responsibilities.Interacts with all levels of state and local government in a way that promotes respect, encourages cooperation, and contributes to excellent performance.Minimum Qualifications:Must have current Georgia POST PBLE (Post Basic Law Enforcement) Certification.Twelve months of fraud investigation or related experience.Law enforcement experiencePreferred Qualifications:Completion of a Bachelor's degree from an accredited four-year college or university with a major in Criminal Justice or similarly related degree.Digital Forensics Experience.Certified Fraud Examiner.Demonstrated analytical skills.The State of Georgia is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.

Job Description

Criminal Investigator - Medicaid Fraud DivisionExplore a world of opportunity with the State of Georgia! Georgia State Government is a large enterprise, composed of various agencies and entities with a common goal to improve the lives of Georgia's more than 10 million citizens! Join Team Georgia and impact lives everyday while receiving a robust benefits package designed for every stage of your career!The mission of the Department of Law is to serve the citizens of the State of Georgia by providing legal representation of the highest quality to the agencies, officers and employees of state government and by honorably and vigorously carrying out the constitutional and statutory responsibilities of the Attorney General. The position filled through this announcement will serve in the Investigations section of our Medicaid Fraud Division.Duties & Responsibilities:Investigators conduct health care fraud investigations.Assists criminal justice personnel, including, but not limited to, Analysts, Auditors, and Prosecutors in conducting on-site health care fraud and patient abuse investigations.Develops necessary knowledge and skills for using computer software programs in unit investigations.Maintains and applies professional knowledge of current trends and developments related to work unit assignments.Positions require current proof of POST Certification.Responds to assignments and requests for assistance in health care fraud and patient abuse investigations in a timely manner.Assists in executing and planning on-site search warrants to obtain evidence of health care fraud and patient abuse.Will be issued a firearm and/or less lethal equipment (e.g. pepper spray).Assists in preparing charts, schedules, and presentations for the prosecution of health care fraud cases.Follows appropriate laws, guidelines, and policies in maintaining the chain of custody for evidence.Collects, reviews, and evaluates the necessary documents to identify and investigate health care fraud and patient abuse, including medical records, health care providers' billing records, and records.Assists in developing databases to analyze appropriate medical data. Enters data into databases and analyzes the data for evidence.Assists in conducting source and expenditure analyses and cash flow analyses of suspects in health care fraud investigations and patient abuse investigations.Assists in searching public records, governmental databases, and commercial databases for evidence of health care fraud and patient abuse allegations.Assists the appropriate parties in identifying potential assets subject to seizure due to health care provider fraud.Utilizes computers and the appropriate software to conduct health care fraud and patient abuse investigations.Demonstrates a basic knowledge of computer software in creating databases, spreadsheets, graphs, and presentations.Demonstrates the appropriate computer skills to conduct health care fraud investigations.Prepares appropriate reports in a timely, thorough, and accurate manner.Presents courtroom testimony utilizing proper courtroom demeanor and assists prosecutors in coordinating pre-trial activities.Maintains supplies, reports, equipment, and relationships with other agencies according to established Unit requirements.Maintains professional knowledge of current trends and developments in the field and applies pertinent new knowledge to the performance of other responsibilities.Interacts with all levels of state and local government in a way that promotes respect, encourages cooperation, and contributes to excellent performance.Minimum Qualifications:Must have current Georgia POST PBLE (Post Basic Law Enforcement) Certification.Twelve months of fraud investigation or related experience.Law enforcement experiencePreferred Qualifications:Completion of a Bachelor's degree from an accredited four-year college or university with a major in Criminal Justice or similarly related degree.Digital Forensics Experience.Certified Fraud Examiner.Demonstrated analytical skills.The State of Georgia is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.