Medicare Fraud Investigator - Johnson City, NY or Camp Hill, PA
HP - Johnson City, NY

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Medicare Fraud Investigator - Johnson City, NY or Camp Hill, PA - 1027556

          Description

              Fraud Investigator

              This position is for a fraud investigator for the Eastern Benefit Integrity Support center (EA-BISC) working with a mission to detect and deter fraud and abuse in the Medicare program for Parts A and B in the state of New York and New Jersey. . This position requires the individual to use a variety of tools to initiate referrals, identify subjects and develop investigations, including referrals to law enforcement, education, overpayment recovery and other administrative actions. The individual will work with internal resources and external agencies to develop investigations and corrective actions as well as respond to requests for data and support.

              Prerequisites: Bachelor degree preferred, 3 – 5 years Medicare experience, and a law enforcement background; strong investigative skills; strong communication and organization skills; experience in reviewing claims for technical requirements, analyzing data and developing fraud investigations

              Essential Functions: ability to perform research and draw conclusions; ability to present issues of concern, citing regulatory violations, alleging schemes or scams to defraud the Government; ability to organize a case file, accurately and thoroughly document all steps taken; ability to communicate effectively and professionally internally and externally and compose correspondence, reports, and referral summary letters; ability to educate providers, provider associations, law enforcement; other contractors and beneficiary advocacy groups on program safeguard matters; ability to interpret laws and regulations; ability to handle confidential information; ability to report work activity on a timely basis; ability to work independently and as a member of a team to deliver high quality work; ability to attend meetings, training, and conferences, overnight travel required

              Qualifications
              Education and Experience Required:

              This position will have the Prerequisite as our normal investigative position, but would like to see candidates where there skills may have been obtained through a law enforcement background.
              • Bachelor degree preferred and three to five years investigative experience
              • Strong investigative skills
              • Strong communication and organization skills
              • Experience in reviewing claims for technical requirements, performing medical review, and/or developing fraud cases
              • Strong PC knowledge and skills
              • Bachelor degree preferred and three to five years investigative experience
              • Strong investigative skills
              • Strong communication and organization skills
              • Experience in reviewing claims for technical requirements, performing medical review, and/or developing fraud cases
              • Strong PC knowledge and skills

              Knowledge and Skills:
              • Ability to perform research and draw conclusions
              • Ability to present issues of concern, citing regulatory violations, alleging schemes or scams to defraud the Government
              • Ability to organize a case file, accurately and thoroughly document all steps taken
              • Ability to compose correspondence, reports and referral summary letters
              • Ability to educate providers, provider associations, law enforcement, other contractors and beneficiary advocacy groups on program safeguard matters
              • Ability to communicate effectively, internally and externally
              • Ability to interpret laws and regulations
              • Ability to handle confidential material.
              • Ability to report work activity on a timely basis.
              • Ability to work independently and as a member of a team to deliver high quality work
              • Ability to attend meetings, training, and conferences, overnight travel required

              Job - Services
              Primary Location - United States-New York-Johnson City
              Other Locations - United States-Pennsylvania-Camp Hill
              Schedule - Full-time
              Job Type - Experienced
              Shift - Day Job
              Travel - Yes, 25 % of the Time

              About this company
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              Hewlett-Packard Company, or HP, is a multinational information technology corporation headquartered in Palo Alto, California, USA. HP got...