Job DescriptionSGI Global is seeking a Health Care Fraud Auditor for the United States Attorneys' Office in Oxford, MSResponsibilitiesServe as the principal investigator responsible independently supporting the Health Care Fraud unit by providing a wide variety of investigative services to one or more Assistant United States Attorneys (AUSA) involved in criminal and civil prosecutions.Provide investigative support and research assignments require knowledge in investigation of complex legal matters in compliance with Federal Medicare and Medicaid regulations.Provide health care investigative services to include, but not limited to the following: Provides a variety of investigative and research services to support the Health Care Fraud (HCF) Unit. Review financial records Review complex legal and regulatory documents and summarize contents Conduct research as needed Develops HCF case referrals. Ensure that HCF referrals meet agency and United States Attorney's...
Office (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. Help 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. Performs other related duties as assigned.Qualifications Strong preference for someone with health care experience, including but not limited to, compliance and/or auditing duties.
Skill in conducting interviews with witnesses and preparing written summaries of interviews. Skill in reviewing complex legal and regulatory documents and summarizing their contents. Skill in reviewing financial records and preparing spreadsheets of financial transactions (e.g., check spreads, etc.).
Skill in reviewing, sorting, and analyzing data with computer software programs including MS Excel and Access. Knowledge and ability in working with investigators and attorneys on legal matters. Must be a United States citizen.SGI Global provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws.Job Posted by ApplicantPro
SGI Global, LLC