Talent.com
Healthcare Fraud Investigator
Healthcare Fraud InvestigatorContact Government Services, LLC • Baltimore, MD, US
Healthcare Fraud Investigator

Healthcare Fraud Investigator

Contact Government Services, LLC • Baltimore, MD, US
30+ days ago
Job type
  • Full-time
Job description

Job Description

Job Description
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

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

Create a job alert for this search

Healthcare Fraud Investigator • Baltimore, MD, US

Similar jobs

Research and Integrity Officer (Contingent II - Grant Funded)

InsideHigherEdBowie, Maryland, United States
Temporary

JR101562 Research and Integrity Officer (Contingent II - Grant Funded) (Open).Non-Regular Fixed Term (Fixed Term).The Research Compliance & Integrity Officer leads and coordinates Bowie State Unive...Show more

 • Promoted

Mail Processor - No Experience Required

Postal Jobs AssistShrewsbury, Pennsylvania, United States
Full-time

USPS is accepting applications for PSE Mail Processing Clerks nationwide.This role is vital to ensuring the timely and accurate processing of mail.USPS provides comprehensive training to help you s...Show more

 • Promoted

Compliance Analyst

MANTECHFort Meade, MD, United States
Full-time

Responsibilities include but are not limited to:.Technical Reports (TR) Management: Process TRs and coordinate with analysts and corporate teams to ensure timely resolution.Metrics and Reporting: P...Show more

 • Promoted

Board Certified Behavior Analyst

Indenovo Global Search & SelectionMD, United States
Full-time

The Supervising Behavior Analyst (SBA) is a credentialed healthcare professional responsible for direct clinical case management for clients.Duties include conducting assessments, developing and mo...Show more

 • Promoted

Healthcare Fraud Investigator: Litigation Support

CGS Federal (Contact Government Services)Baltimore, Maryland, United States
Full-time

A government services contractor is seeking a Healthcare Fraud Investigator to support legal efforts on a large government project.The role involves analyzing data, preparing legal documents, and a...Show more

 • Promoted

HEALTHCARE INNOVATION GROUP LEADER

Adhesives ResearchGlen Rock, PA, United States
Full-time

Job Summary: Manages a team of chemists/scientists/technicians and executes pressure sensitive adhesive (PSA) tape prototype development, scale-up, and product launch in various applications.The gr...Show more

 • Promoted

Mgr MD Reg and Rev Mgmt

HH MedStar Health Inc.MD, United States
Full-time

About the Job General Summary of Position Performs and is responsible for various regulatory functions to maintain compliance with the mandates of the Health Services Cost Review Commission a uniqu...Show more

 • Promoted

Healthcare Medical Insurance Auditor

LumelightPikesville, MD, United States
Full-time

Account Coordinator (Pharmacy Auditor).Lumelight is an integrated workplace administration and compliance business.We serve the brokers and third-party administrators who support employers in the c...Show more

 • Promoted

Inpatient Coder - Trauma Experience Required

1st Choice, LLCMD, United States
Full-time

Under direct supervision, the Senior Inpatient Coder accurately codes hospital inpatient accounts for appropriate reimbursement, research, statistics, and compliance with federal and state regulati...Show more

 • Promoted

Become a Surrogate, give the miracle of life, and earn up to $115,000 from home!

Giving Tree SurrogacyNew Freedom, PA, US
Full-time +1

We are looking for a passionate individual with a sense of responsibility and willingness to help create families to join us as a surrogate.In this role, you will be instrumental in supporting indi...Show more

 • Promoted

Mgr MD Reg and Rev Mgmt

Medstar Research InstituteMD, United States
Full-time

About the Job General Summary of Position Performs and is responsible for various regulatory functions to maintain compliance with the mandates of the Health Services Cost Review Commission a uniqu...Show more

 • Promoted

Healthcare Programs Offered - Entry Level Training Programs

DreamboundBowie, Maryland, United States
Full-time

Note : This is an educational program, not a job.Successful completion of the program does not guarantee employment but will equip you with valuable skills for the healthcare job market.Are you pas...Show more

 • Promoted

Retail Mortgage Loan Originator

TruistGambrills, MD, United States
Full-time +2

The position is described below.If you want to apply, click the Apply Now button at the top or bottom of this page.After you click Apply Now and complete your application, you'll be invited to crea...Show more

 • Promoted

Workers' Compensation Claims Adjuster (CONTRACT)

Argonaut Management Services, IncBaltimore, Maryland, United States
Full-time

Argo Group is an underwriter of specialty insurance products in the property and casualty market.Argo offers a full line of products and services designed to meet the unique coverage and claims-han...Show more

 • Promoted

Senior Healthcare & Research Transactions Counsel

Inside Higher EdBaltimore, MD, United States
Full-time

A leading academic institution in Baltimore is seeking a Senior Associate General Counsel specializing in healthcare and transactions.This role involves acting as a legal expert on healthcare acqui...Show more

 • Promoted

Healthcare Services Associate Analyst

T Rowe PriceBaltimore, MD, United States
Full-time

Rowe Price, we identify and actively invest in opportunities to help people thrive in an evolving world.As a premier global asset management organization with more than 85 years of experience, we p...Show more

 • Promoted

Board Certified Behavior Analyst

Maxim HealthcareBowie, MD, United States
Full-time

Your expertise matters! Step into leadership as a BCBA Clinical Supervisor and enjoy autonomy, monthly bonuses, and CEU support.Start your next chapter in behavioral health today!.Clinical Supervis...Show more

 • Promoted

Oracle Health Solution Adviso

Axelon Services CorporationArnold, Maryland, US
Full-time

Job Title: Oracle Health Solution Advisor Location:Remote Position Overview Seeking an Oracle Health Solution Advisor (Scheduling) to support the Department of Veterans Affairs (VA) Electronic Heal...Show more