Title: Health Care Fraud Investigator

Location: United States Attorney's Office

101 South Edgeworth Street, 4th Floor

Greensboro, NC 27401

Job Type: Full-time On-site

Salary: Commensurate with experience

Experience: 4 years minimum

Education: Bachelor's degree in related field

Date Updated: April 16, 2024

Company Description

Now is the time to join Lindahl Reed, Inc. Lindahl Reed is a professional services company that provides program management, engineering and technical, and management advisory services to federal, state, institutional, and commercial customers nationwide. We offer expertise in the health, energy, and environmental markets. Lindahl Reed was founded on the belief that we can advance a safer, healthier, and more resilient and sustainable world. Our solutions allow clients to work smarter and gain unique insights and understanding into their organization as well as improve decision-making to help meet their mission, business, compliance, and operational challenges – now and into the future. We are hiring creative, motivated, and talented people with a passion for doing what's right, what's smart, and what works.

Description/Job Summary

Lindahl Reed is hiring a Health Care Fraud Investigator to support the United States Attorney’s Office (USAO) in Greensboro, NC. The investigator will conduct thorough and systematic investigations relating to Criminal and Civil Health Care Fraud matters within the jurisdiction of the USAO. The investigator will handle cases independently, as lead agent or as a team member. Cases may involve sensitive matters or prominent individuals, organizations, or corporations and may also involve obscure leads, uncooperative witnesses, and conflicting evidence.

Position Responsibilities

Plan and conduct investigations of a complex and difficult nature; perform quantitative, qualitative, or other analysis of relevant facts; and prepare the results to support the mission of the USAO. Investigations may be conducted in conjunction with other federal agencies such as the Department of Health and Human Services, the Federal Bureau of Investigation; the Defense Criminal Investigative Service; and the Drug Enforcement Administration.
Research background information using various databases and sources (such as health care provider data)
- Identify subjects to investigate and develop leads.
- Conduct interviews.
- Collect and process evidence.
- Prepare reports, charts and exhibits.
- Build financial investigations regarding the subjects and their conduct.
Develop an understanding of all applicable federal, state, or local law to the extent necessary to make sound decisions on the direction and scope of investigations.
Determine proof required to affix responsibility for violations, and develop methods for obtaining, preserving, and presenting evidence effectively.
Develop an understanding of all applicable federal, state, or local law to the extent necessary to make sound decisions on the direction and scope of investigations.
Determine proof required to affix responsibility for violations, and develop methods for obtaining, preserving, and presenting evidence effectively.
Work with the assigned Assistant United States Attorneys (AUSAs), Paralegal Specialists and supervisory attorneys to determine applicable statutory and regulatory law and identify possible violations.
Perform a variety of ancillary services in direct support of assigned cases and matters.
- o i. Use electronic databases to identify assets, documents, and other physical evidence.
- o ii. Prepare interim and final reports on progress of investigations for use by AUSAs and supervisory attorneys.
- o iii. Arrange for secure storage, preservation, organization, and indexing of voluminous documentary evidence.
- o iv. Assist in compilation and analysis of documents and physical evidence, and creation of charts, graphs, videotapes, and other audio-visual materials for use in hearings and at trial. Assist in developing the most efficient method for conducting investigations and identify any resources that may be needed.
Initiate contacts with federal, state, and local officials, and other organizations and individuals related to subject of investigation for the purpose of gathering facts, obtaining statements, learning sequences of events, obtaining explanations, and otherwise advancing investigative objectives.
Examine books, ledgers, payroll records, cost reports, billing statements, invoices, correspondence, computer data and other records pertaining to the transactions, events, or allegations under investigation.
Establish and verify relationships among all facts and evidence obtained or presented to confirm authenticity of documents, corroborate witness statements, and otherwise build proof necessary to successful case resolution.

Qualifications, Skills, and Experience:

Bachelor's degree in a related field.
4 years minimum experience in planning and conducting civil or criminal complex investigations concerning misuse of public, private, or insurance funds.
Knowledge of legal and law enforcement terms and procedures
Skill in using word processing, spreadsheet software, and Microsoft Office software programs.
Working knowledge of current investigative techniques including the use of commercial databases and other sources of information.
Excellent written and oral communication skills
Valid driver’s license.
U.S. Citizenship and a seven or ten-year minimum background investigation

Preferred Qualifications:

Experience in analyzing, organizing, and presenting a large volume of data through the use of common software programs is preferred (e.g. Excel).
Experience in reviewing and understanding medical records and knowledge of medical billing procedures is preferred.
Experience in interviewing potential witnesses is preferred.
Certified Fraud Examiner, Financial Crime Certification, or Certified Health Care Fraud Investigator credentials are preferred.

Benefits

The following benefits are available to benefit-eligible employees:

Medical Benefits
Dental Benefits
Vision Benefits
Retirement Plan
Company paid Basic Life, Long-Term Disability and Short-Term Disability
Flexible Spending Account
Paid Time Off/ 11 Federal Holidays
Professional and Educational Development
And other benefits

All positions require a background check after acceptance of our offer. The selected candidate may be eligible to begin employment before the background check has been finalized.

However, continued employment with Lindahl Reed will be contingent upon the results of candidate’s reference/background check. This position may require special credentialing,

clearance, and access as a condition of employment. In the event the government or client does not sponsor or approve your clearance, it may result in termination of your employment.

We are an Equal Employment/Affirmative Action employer. We do not discriminate in hiring on the basis of sex, gender identity, sexual orientation, race, color, religious creed, national origin, physical or mental disability, protected Veteran status, or any other characteristic protected by federal, state, or local law.

For more information, view the EEO is the Law Poster and Pay Transparency Statement

Applicants have rights under Federal Employment Laws view the following posters to see more information:

Family & Medical Leave

Employee Rights

This job description is not a contract and may be adjusted as deemed appropriate in Lindahl Reed’s sole discretion.

Lindahl Reed Inc.

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