Senior Civil Health Care Fraud Investigator

Job Description

Job Description

Senior Civil Health Care Fraud Investigator

Employment Type: Full Time, Mid-Level

Department: Litigation Support 

CGS is seeking a Senior Civil Health Care Fraud Investigator to join our team supporting the legal mission of a large federal agency in Harrisburg, PA. This position will allow candidates to demonstrate expertise in fraud investigations while supporting a federal agency. 

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.

Job Description:

• Supports the planning and conduction of investigations
• Assists Assistant United States Attorneys (AUSAs) in the investigation of matters in conjunction
  with federal agents, to determine whether there have been violations of Federal Statutes, e.g.,
  False Claims Act, Stark Law, and Anti-Kickback Act.
• Works and regularly communicates with AUSAs to identify possible violations or causes of
  action, determines proof required to assist in affixing legal responsibility, and devises methods
  for obtaining, preserving, and presenting such evidence
• Decides upon the most effective methods for planning, scheduling, and conducting
  investigations, and identifies required resources. Recommends methods for conducting
  investigations, including interviews, subpoenas, and depositions. Secures participation of
  appropriate law enforcement agents in execution of these investigative methods
• Identifies and presents AUSAs with potential investigations through review of the news,
  databases, and regular communications with representatives of Government agencies and private
  industry.
• Contacts federal, state, and local officials, as well as business representatives, to gather
  information, documents, and statements on current or potential investigations, as well as
  coordinate investigative activities.
• Assists AUSAs with the identification, locating, and interviewing of witnesses. Conducts
  surveillance of suspects with appropriate law enforcement agencies. Communicates with counsel
  of subjects and witnesses
• Prepares appropriate memos and reports on contacts, interviews, and surveillance
• Examines, analyzes, presents, and secures evidence such as documents, emails, policies, text
  messages, payrolls, financial statements, billing statements, invoices, correspondence, computer
  data, and other records pertaining to the transactions, events, or allegations under investigation.
• Research and reviews laws, rules, regulations, and policies to determine whether health care
  billings were improper. Identifies and interviews any relevant Governmental or business
  representative pertaining to the propriety of the billings
• Traces funds derived from fraud and identifies assets of subjects
• Confirms authenticity of documents, corroborates witness statements, and otherwise builds proof
  necessary for successful litigation
• Arranges for the integrity of evidence through secure storage, preservation, organization, and
  indexing of voluminous physical and electronic evidence.
• Regularly updates AUSAs on status of case. Prepares interim and final reports on progress of
  investigations for use by AUSAs and supervisory attorneys. Includes significant findings and
  conclusions, recommendations for additional investigative actions, and candid assessments of
  strengths and weaknesses of witnesses, documentary evidence, and other aspects of case
• Assists AUSAs with preparation for litigation and trial
• Provides analytical advice and assistance with compiling documents and physical evidence, and
  creating charts, graphs, videotapes, and other audio-visual materials for use by AUSAs in
  motions and at trial
• Provides advice to AUSA on selection of witnesses and ensures their attendance through
  subpoena or otherwise.

Job Requirements:

• Bachelor’s degree in law enforcement, criminal justice, accounting, finance or related field.
• Minimum ten (10) years of experience in any combination of law enforcement, criminal 
  justice experience, and health care fraud investigation.
• Experience testifying in court matters
• Proficient in Microsoft Office software programs (i.e., Word, Excel, Outlook, etc.)
• U.S. Citizenship and ability to obtain adjudication for the requisite background investigation
  
• Preferred: 
  - CPA Certification
  - Experience working with a federal or state law enforcement entity

Our commitment:

Contact Government Services (CGS) strives to simplify and enhance government bureaucracy through the optimization of human, technical, and financial resources. We combine cutting edge technology with world-class personnel to deliver customized solutions that fit our clients’ specific needs. We are committed to solving the most challenging and dynamic problems.

For the past nine years we’ve been growing our government-contracting portfolio, and along the way we’ve created valuable partnerships by demonstrating a commitment to honesty, professionalism, and quality work.

Here at CGS we value honesty through hard work and self-awareness, professionalism in all we do, and to deliver the best quality to our consumers mending those relations for years to come.

We care about our employees. Therefore, we offer a comprehensive benefits package:

- Health, Dental, and Vision

- Life Insurance

- 401k

- Flexible Spending Account (Health, Dependent Care, and Commuter)

- Paid Time Off and Observance of State/Federal Holidays

Contact Government Services, LLC is an Equal Opportunity Employer. Applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Join our team and become part of meaningful government innovation!

Explore additional job opportunities with CGS on our Job Board:

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For more information about CGS please visit: or contact:

Email:  View email address on ziprecruiter.com

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We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. 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.