TDI-Investigator V (Fraud Investigator)

divh2TDI-Investigator V (Fraud Investigator)/h2pThis position performs advanced (senior-level) investigative work involving planning, organizing, and conducting investigations. Investigates fraudulent insurance acts committed by health care providers, attorneys, claimants, and employers within the state of Texass workers compensation system. Prepares criminal case investigative reports for prosecutors. Performs moderately complex analyses of factual and legal situations and documents findings. Acts as liaison with external entities, such as Special Investigative Units (SIUs) of insurance companies and with state and federal law enforcement and other governmental agencies. May frequently plan and organize investigative activities and may develop and provide training on investigative techniques, policies, and procedures for conducting investigations. May supervise the work of others. Works under minimal supervision with considerable latitude for the use of initiative and independent judgment./ppThis position:/pulliConducts workers compensation fraud and criminal investigations./liliInterviews witnesses and suspects and takes oral and written statements./liliReviews complex financial and business records, forms, reports, and other documents to extract evidence and prepare investigative reports./liliDocuments investigative activity using a case management system; organizes and maintains case files and evidence./liliCoordinates criminal investigations and maintains contact with various state or federal law enforcement organizations related to insurance fraud matters;/liliMay frequently plan and organize investigative activities and may develop and provide training on investigative techniques, policies, and procedures for conducting investigations;/liliProvides testimony and technical support with judicial proceedings by reviewing legal aspects of investigations and recommending action as appropriate;/liliPrepares summary reports for the chain of command; and/liliPerforms other duties as assigned./li/ulpQualifications:/pulliGraduation from an accredited four-year college or university with a degree in criminal justice, finance, or a related field./liliPlus three years experience in financial fraud investigation, complex financial analysis, or criminal investigation./liliRegular work attendance./liliExperience and education relevant to the position requirements may be substituted for one another on a year-for-year basis./li/ulpThis position requires the applicant to be eligible to apply for access to the Texas Criminal Justice Information System. For eligibility, see: a href=https://www.dps.texas.gov/administration/crime_records/docs/txCJISSysAccPolicy.pdfhttps://www.dps.texas.gov/administration/crime_records/docs/txCJISSysAccPolicy.pdf/a TDI will conduct a criminal background check on all final candidates. An applicant who has been convicted of, received deferred adjudication for, or has an open arrest for a criminal offense, may be disqualified from employment./ppAdditional job details:/pulliThe interview will include a writing test./liliRegistration, License, or Certification Required: Certified Fraud Examiner (CFE) certification, or eligible for CFE certification. Required to obtain CFE certification within one year of hire or at the managers discretion. Required to maintain CFE certification in accordance with requirements established by the Association of Certified Fraud Examiners./li/ulpThis position requires demonstrated knowledge of:/pulliPersonal computers and a variety of software packages such as Microsoft Office software applications, including Word, Excel, PowerPoint, Access, Outlook, SharePoint, and Teams;/liliLocal, state, and federal laws related to insurance, workers compensation, and criminology;/liliTexas Labor Code, Texas Penal Code, and Code of Criminal Procedures;/liliPolice practices and procedures;/liliGrand jury and courtroom procedures;/liliCriminal investigative processes;/liliPolice report writing;/liliInterview and interrogation techniques;/liliRules of Evidence;/liliPlanning and conducting complex investigations; and/liliState laws, rules, procedures, and regulations relevant to job requirements./li/ulpThis position requires demonstrated skill in:/pulliPlanning, decision making, and problem solving;/liliCritical thinking;/liliEffectively obtaining statements from witnesses and suspects./liliNetworking;/liliOrganizing and prioritizing workload, performing multiple tasks, and devising solutions to problems;/liliWriting reports and documenting activities in a case management system;/liliUsing personal computers and software packages to enter and extract data for analysis from related systems and programs;/liliUsing Microsoft Office software applications, including Word, Excel, Outlook, and SharePoint; and/liliUsing personal computers sufficient to enter and extract data from related systems and programs such as Centralized Accounting Payroll and Personnel (CAPPS) and other systems required to perform the job./li/ulpThis position requires the demonstrated ability to:/pulliAnalyze and solve work-related problems and work independently on a variety of administrative work and technical assignments;/liliManage and coordinate multiple tasks and priorities to meet necessary deadlines;/liliWork both independently and as a team player;/liliConduct investigations related to workers compensation insurance fraud;/liliCommunicate complex information effectively, both orally and in writing, to coworkers and the general public;/liliComprehend and apply criminal statutes, including the Texas Insurance Code;/liliAnalyze correspondence, business records, and other documents to extract relevant information;/liliResearch rules and statutes and apply knowledge to individual cases;/liliEffectively and efficiently analyze complex financial statements, reports, and forms;/liliPresent complex data, policies, analyses, and recommendations in a clear, concise, and compelling manner;/liliAudit accounts, statements, reports, policy forms, and other records of insurance companies;/liliExercise independent judgment and use discretion in making decisions relative to assigned investigation;/liliEstablish and maintain effective working relationships with a wide range of people with varied skills, knowledge, and backgrounds, including TDI employees, the public, the insurance industry, and elected officials and their staff;/liliDrive vehicles for extended periods;/liliEffectively write an investigation report;/liliWork independently and meet deadlines;/liliMaintain the confidentiality of sensitive information;/liliMaintain professional demeanor and conduct;/liliFollow the chain of command and directions; and/liliLift 50 lbs./li/ul/div