Investigator - Medicaid Fraud - Civil

Mission 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 Department of Law is organized into the Executive Office, five legal divisions, four specialty units and an operations division. 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. Assist criminal justice personnel, including Analysts, Auditors, and Prosecutors, in conducting on‑site health care fraud and patient abuse investigations. May be issued a firearm and/or less lethal equipment. Develop the necessary knowledge and skills for using computer software programs in unit investigations. Maintain and apply professional knowledge of current trends and developments related to work unit assignments. Positions are typically non‑POST and do not require POST certification. Respond to assignments and requests for assistance in health care fraud and patient abuse investigations in a timely manner. Review documentation, conduct interviews, and gather intelligence information for health care fraud investigations and patient abuse investigations. Participate in the planning and gathering of information for investigations involving health care fraud and patient abuse investigations. Assist in executing on‑site search warrants to obtain evidence of health care fraud and patient abuse. Assist in the identification and seizure of health care fraud evidence during the execution of on‑site search warrants. May be issued firearms and/or less lethal equipment (for example pepper spray). Assist in preparing charts, schedules, and presentations for the prosecution of health care fraud cases. Follow appropriate laws, guidelines, and policies in maintaining the chain of custody for evidence. Collect, review, and evaluate the necessary documents to identify and investigate health care fraud and patient abuse, including medical records, health care providers' billing records, and other records. Assist in developing databases to analyze appropriate medical data. Enter data into databases and analyze the data for evidence. Assist in conducting source and expenditure analyses and cash flow analyses of suspects in health care fraud investigations and patient abuse investigations. Assist in searching public records, governmental databases, and commercial databases for evidence of health care fraud and patient abuse allegations. Assist the appropriate parties in identifying potential assets subject to seizure due to health care provider fraud. Assist the appropriate parties in organizing, analyzing, and processing items of evidence and other documentation for investigation and prosecutorial purposes in health care fraud and patient abuse investigations. Utilize computers and the appropriate software to conduct health care fraud and patient abuse investigations. Demonstrate a basic knowledge of computer software in creating databases, spreadsheets, graphs, and presentations. Demonstrate the appropriate computer skills to conduct health care fraud investigations. Prepare appropriate reports in a timely, thorough, and accurate manner. Prepare thorough and accurate reports documenting interviews of witnesses and suspects, the execution of search warrants and seizure of evidence, the analyses of financial databases and conclusions, public record and database searches and conclusions, and all investigative activities. Distribute copies of the reports to the appropriate parties in a timely manner. Present courtroom testimony utilizing proper courtroom demeanor and assist prosecutors in coordinating pre‑trial activities. Provide accurate testimony concerning health care fraud investigations and patient abuse investigations. Demonstrate knowledge of court system operations and methods of presenting testimony. Coordinate and prepare courtroom testimony with the appropriate prosecuting attorney. Demonstrate skills as a witness and/or evidence coordinator on behalf of the prosecuting attorneys. Maintain supplies, reports, equipment, and relationships with other agencies according to established Unit requirements. Maintain assigned equipment based on Department policy and standards. Complete applicable reports in a timely manner. Develop relationships and liaisons with other agencies, departments, and the public. Maintain professional knowledge of current trends and developments in the field and apply pertinent new knowledge to the performance of other responsibilities. Participate in seminars and professional meetings when available and approved in advance. Read up‑to‑date articles, books, and periodicals. Apply new knowledge to assigned responsibilities. Interact with all levels of state and local government in a way that promotes respect, encourages cooperation, and contributes to excellent performance. Treat all other state and local personnel fairly and without preferential treatment. Communicate accurate information in a professional and courteous manner. Accept direction and feedback from supervisors. Accept responsibility for mistakes and take action to prevent similar occurrences. Use appropriate established channels of communication. Maintain relationships and liaisons with other agencies, departments, and the public according to Unit requirements. Minimum Qualifications Twelve months of fraud investigation or related experience. Preferred Qualifications Completion of a Bachelor’s degree from an accredited four‑year college or university with a major in Criminal Justice, Healthcare Administration, Accounting, Business and Finance. Law enforcement experience. Demonstrated analytical skills. Salary Starting in the $50's and commensurate with experience. Additional Information Due to the volume of applications received, we are unable to provide information on application status by phone or e‑mail. All applicants will be considered but may be screened for the preferred qualifications of the position and may not necessarily receive an interview. Selected candidates are subject to a State of Georgia tax records check and a criminal background investigation. Only candidates chosen for interviews will be notified due to the high volume of applications. 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. #J-18808-Ljbffr Georgia Piedmont Technical College