TEAM GEORGIA CAREERS A world of opportunity.

Login

Banner of Smiling People

Investigator - Medicaid Fraud Division

📁
Legal
💼
Law, Georgia Department of

*To move forward in the recruiting process ALL applicants are required to:

 

  • Attach a current Resume
  • Cover Letter
  • Attach "Department of Law Employment Application(click link to obtain: http://law.georgia.gov/careers/application-forms)
  • Attach copies of official undergraduate transcripts (unofficial accepted during application process)
  • If the file is too large to attach please email the document(s) to hr@law.ga.gov to include the position title - application material(s) in the subject line.

 

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. Assists criminal justice personnel, including, but not limited to, 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.*

Develops necessary knowledge and skills for using computer software programs in unit investigations.  Maintains and applies professional knowledge of current trends and developments related to work unit assignments.  Positions are typically non-POST and do not require POST Certification.

Develops necessary knowledge and skills for using computer software programs in unit investigations.  Maintains and applies professional knowledge of current trends and developments related to work unit assignments.  Positions are typically non-POST and do not require POST Certification.

 

Responds to assignments and requests for assistance in health care fraud and patient abuse investigations in a timely manner.

  • Responds to assignments and requests for assistance by reviewing documentation, conducting interviews, and gathering intelligence information for health care fraud investigations and patient abuse investigations.
  • Participates in the planning and gathering of information for investigations involving health care fraud and patient abuse investigations.
  • Assists in executing on-site search warrants to obtain evidence of health care fraud and patient abuse. Assists 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 (e.g.  pepper spray).*
  • Assists in preparing charts, schedules, and presentations for the prosecution of health care fraud cases.
  • Follows appropriate laws, guidelines, and policies in maintaining the chain of custody for evidence.
  • Collects, reviews, and evaluates the necessary documents to identify and investigate health care fraud and patient abuse, including medical records, health care providers' billing records, and records.
  • Assists in developing databases to analyze appropriate medical data. Enters data into databases and analyzes the data for evidence.
  • Assists in conducting source and expenditure analyses and cash flow analyses of suspects in health care fraud investigations and patient abuse investigations.
  • Assists in searching public records, governmental databases, and commercial databases for evidence of health care fraud and patient abuse allegations.
  • Assists the appropriate parties in identifying potential assets subject to seizure due to health care provider fraud.
  • Assists 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.

 

Utilizes computers and the appropriate software to conduct health care fraud and patient abuse investigations.

  • Demonstrates a basic knowledge of computer software in creating databases, spreadsheets, graphs, and presentations.
  • Demonstrates the appropriate computer skills to conduct health care fraud investigations.

 

Prepares appropriate reports in a timely, thorough, and accurate manner.

  • Prepares thorough and accurate reports documenting interviews of witnesses and suspects in a timely manner.
  • Prepares thorough and accurate reports documenting the execution of search warrants and the seizure of evidence in a timely manner.
  • Prepares thorough and accurate reports documenting the analyses of financial databases and conclusions of the analyses in a timely manner.
  • Prepares thorough and accurate reports documenting public record and database searches and conclusions from the searches in a timely manner.
  • Prepares thorough and accurate case reports for all investigative activities in a timely manner.
  • Distributes copies of reports to the appropriate parties in a timely manner.

 

Presents courtroom testimony utilizing proper courtroom demeanor and assists prosecutors in coordinating pre-trial activities.

  • Provides accurate testimony concerning health care fraud investigations and patient abuse investigations.
  • Demonstrates knowledge of court system operations and methods of presenting testimony.
  • Coordinates and prepares courtroom testimony with the appropriate prosecuting attorney.
  • Demonstrates skills to be a witness and/or evidence coordinator on behalf of the prosecuting attorneys to ensure that all evidence and witnesses are available for presentation.

 

Maintains supplies, reports, equipment, and relationships with other agencies according to established Unit requirements.

  • Maintains assigned equipment based on Department policy and standards. Completes applicable reports in a timely manner.
  • Demonstrates skills that allow the development of relationships and liaisons with other agencies, departments, and the public.

 

Maintains professional knowledge of current trends and developments in the field, and applies pertinent new knowledge to the performance of other responsibilities.

  • Participates in seminars and professional meetings when available and approved in advance.
  • Maintains professional knowledge by reading up-to-date articles, books, and periodicals.
  • Applies pertinent new knowledge to the performance of assigned responsibilities.

 

Interacts with all levels of state and local government in a way that promotes respect, encourages cooperation, and contributes to excellent performance.

  • Treats all other state and local personnel fairly, giving preferential treatment to no one.
  • Communicates accurate information to all other state personnel in a professional and courteous manner that conveys a willingness to assist.
  • Accepts direction and feedback from supervisors and follows through appropriately.
  • Accepts responsibility for mistakes and takes action to prevent similar occurrences.
  • Uses appropriate established channels of communication.
  • Maintains relationships and liaisons with other agencies, departments, and the public according to Unit requirements.

 

The above statements are intended to describe the general nature and level of work being performed by persons assigned to this title.  They may not include all job duties performed by employees on this job title, and every position does not necessarily require these duties.

 

Minimum:

  • Fraud investigation or related experience.

Preferred Qualifications:

 

Preference will be given to applicants who possess one or more items below:

  • POST-Certification
  • Criminal Justice or Business related BA degree 
  • Certified Fraud Examiner
  • Law enforcement experience
  • Demonstrated analytical skills.
  • Experience with social media and digital evidence-based investigations 

     

 

*Requires State training and verification of course passing.

 

Additional Information:

A criminal background check is completed on all candidates; employment is also contingent upon the completion and satisfactory results of the background investigation. Candidates that are being strongly considered for the position will also be required to submit a Department of Law employment application & waiver, Georgia Department of Revenue Tax Clearance letter and copies of official college transcripts.

 

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.  Human Resources maintains the discretion to close the job announcement prior to the closing date if a significant number of applications are received.

Previous Job Searches

My Profile

Create and manage profiles for future opportunities.

Go to Profile

My Submissions

Track your opportunities.

My Submissions

Similar Listings

Law, Georgia Department of

Georgia - Fulton - Atlanta

📁 Legal

Law, Georgia Department of

Georgia - Fulton - Atlanta

📁 Legal

Law, Georgia Department of

Georgia - Fulton - Atlanta

📁 Legal

Team Georgia Careers

Georgia’s workforce is comprised of diverse career opportunities across more than 100 entities. The diligent work of nearly 68,000 employees helps keep Georgia progressive, prosperous, and a place citizens can be proud to call home.
search all openings join our talent community

about state government

Georgia state government is a large enterprise, comprised of more than 80 entities, all with a common goal to improve the lives of Georgia’s 10 million citizens.
learn more

benefits

The health, happiness and well-being of employees is paramount to the State of Georgia. Our total rewards package is designed to provide value and options you can tailor to fit your needs.
explore benefits

internships

Jump start your career with impactful work and real-world experiences! From healthcare, to information technology and much more, your professional development options are limitless. Discover the various opportunities offered to students throughout the state.
see internships

faqs

Have a question about applying for a job? Want to know how to review your application status? We have the answers to these questions and more!
find answers

Spotlight Agencies

Georgia Department of Juvenile Justice   Search Current Openings
Georgia Department of Community Affairs   Search Current Openings
Savannah Technical College   Search Current Openings

Join Our Talent Community

Create a Talent Profile
Sign up

Life in Georgia

Thriving cities and charming towns, beautiful countryside connecting mountain vistas with white-sand beaches, plus a temperate climate offering all four seasons make Georgia one of the very best places to live in the South. Across the state you will find world-class entertainment, professional and recreational sports, and restaurants providing cuisine from around the world. Come experience and enjoy life in Georgia.

Video courtesy of Georgia Department of Economic Development