Insurance fraud investigator Jobs in Houston, TX

Fraud Investigator Child Care Services (Mid-Level)

Location: Greenway Plaza, Houston, TX

Schedule: MondayFriday, 8:00 AM 5:00 PM

Work Setting: In-office only

Parking: Free / Validated

Contract Length: 6 months with possible extension To qualify for this TEMPORARY position, you

MUST have a Bachelor's degree and at least 3-5 years' of relevant experience along with a valid driver's license.

Position Overview

A regional workforce organization is seeking a highly analytical, ethical, and detail-oriented professional to serve as a

Child Care Services (CCS) Fraud Investigator

supporting the Texas Workforce Commission's Child Care Services subsidy program. This role ensures compliance with federal

Child Care & Development Fund (CCDF) regulations, state policies, and local procedures by investigating allegations of

fraud, waste, and abuse involving both parent participants and childcare providers. The Fraud Investigator safeguards due process rights, maintains confidentiality, and upholds program integrity.

Key Responsibilities

• Investigate allegations related to CCS parent eligibility or childcare provider compliance.
• Review eligibility documentation, wage and employment verification, residency records, attendance data, and provider billing submissions.
• Conduct interviews with parents, providers, employers, and relevant third parties.
• Collaborate with CCS eligibility staff, monitoring teams, and state program staff.
• Prepare comprehensive investigative reports detailing findings, evidence, and recommended actions.
• Recommend overpayment calculations and recovery processes as needed.
• Provide documentation and support to state fraud deterrence and compliance monitoring units during appeals or legal proceedings.
• Maintain secure handling of all sensitive personal, financial, and employment records.
• Identify control gaps and recommend improvements to processes or policy application.
• Lead Investigator (senior-level): Supervise and review work performed by mid-level investigators.

Required Qualifications

• Bachelor's degree in Criminal Justice or related field.
• Mid-Level: 35 years of investigative, compliance, fraud detection, auditing, or public benefits experience.
• Experience reviewing income documentation, employment verification, and financial records.
• Strong report writing, documentation, and analytical reasoning skills.
• Ability to objectively interpret and apply federal and state policy.
• Valid Texas driver's license: local travel may be required.

Preferred Qualifications

• Experience working with childcare subsidy programs or public benefit programs.
• Familiarity with Texas Workforce Commission (TWC) policies and childcare eligibility regulations.
• Professional certification (e.g., CFE Certified Fraud Examiner) or similar credential.
• Experience with administrative hearings, compliance monitoring, or program integrity.

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