Healthcare Fraud Investigator
Employment Type: Full-Time, Mid-Level
Department: Litigation Support
CGS is seeking a Healthcare Fraud Investigator to provide Legal Support for a large Government Project in Nashville, TN. The candidate must take the initiative to ask questions to successfully complete tasks, perform detailed work consistently, accurately, and under pressure, and be enthusiastic about learning and applying knowledge to provide excellent litigation support to the client.
CGS brings motivated, highly skilled, and creative people together to solve the government’s most dynamic problems with cutting-edge technology. To carry out our mission, we are seeking candidates who are excited to contribute to government innovation, appreciate collaboration, and can anticipate the needs of others. Here at CGS, we offer an environment in which our employees feel supported, and we encourage professional growth through various learning opportunities.
Responsibilities will Include:
Review, sort, and analyze data using computer software programs such as Microsoft Excel.
Review financial records, complex legal and regulatory documents and summarize contents, and conduct research as needed. Preparing spreadsheets of financial transactions (e.g., check spreads, etc.).
Develop HCF case referrals including, but not limited to:
Ensure that HCF referrals meet agency and USAO standards for litigation.
Analyze data for evidence of fraud, waste and abuse.
Review and evaluate referrals to determine the need for additional information and evidence, and plan comprehensive approach to obtain this information and evidence.
Advise the HCF attorney(s) regarding the merits and weaknesses of HCF referrals based upon applicable law, evidence of liability and damages, and potential defenses, and recommend for or against commencement of judicial proceedings.
Assist the USAO develop new referrals by ensuring a good working relationship with client agencies and the public, and by assisting in HCF training for federal, state and local agencies, preparing informational literature, etc.
Assist conducting witness interviews and preparing written summaries.
Qualifications:
Four (4) year undergraduate degree or higher in criminal justice, finance, project management, or other related field.
Minimum three (3) years of professional work experience in healthcare, fraud, or other related investigative field of work.
Proficiency in Microsoft Office applications including Outlook, Word, Excel, PowerPoint, etc.
Proficiency in analyzing data that would assist in providing specific case support to the Government in civil HCF matters (E.g., Medicare data, Medicaid data, outlier data).
Communication skills: Ability to interact professionally and effectively with all levels of staff including AUSAs, support staff, client agencies, debtors, debtor attorneys and their staff, court personnel, business executives, witnesses, and the public. Communication requires tact and diplomacy.
U.S. Citizenship and ability to obtain adjudication for the requisite background investigation.
Experience and expertise in performing the requisite services in Section 3.
Must be a US Citizen.
Must be able to obtain a favorably adjudicated Public Trust Clearance.
Preferred qualifications:
Relevant Healthcare Fraud experience including compliance, auditing duties, and other duties in Section 3.
Relevant experience working with a federal or state legal or law enforcement entity.
#CJ
...Greenberg-Larraby, Inc. (GLI) is currently looking for a skilled and compassionate Interventional Radiologist to join our team at a well-known hospital facility In this critical role, you will leverage state-of-the-art imaging technology and interventional techniques...
...Medicine; Immunology; Molecular Medicine; Molecular Pharmacology & Experimental Therapeutics; Physiology & Biomedical Engineering; Neuroscience; and Quantitative Health Sciences. The Department plays a central role in fulfilling Mayo Clinics tripartite mission of...
...Job Title : Entry-Level Sushi Chef Assistant [Little or No Experience Required - Will Train] Job Type: Full-time / Part-time Job Summary We are seeking an individual passionate about sushi or Japanese cuisine who is eager to learn a traditional craft. We...
...Inland Truck Parts & Service is currently seeking an experienced Diesel Mechanic / Truck Technician with at least 2years of heavy-duty truck repair experience to join our team in Colorado Springs, Colorado. Compensation: Up to $42.00/hour , based on your experience...
...years. Our corporate legal department in Bryn Mawr, PA services our business nationwide. Hiring for a Legal Assistant or Corporate Paralegal to support an in-house corporate legal department in Bryn Mawr, PA. Duties include but are not limited to managing the calendar,...