Workers Compensation Surveillance Specialist

3 weeks ago

Arlington, United States A.C. Coy Full time
  • Tier One Technologies is looking for a Workers Compensation Surveillance Specialist (WCSS) to provide support investigating two types of suspected workers’ compensation fraud: claimant fraud and medical provider fraud.
  • This multi-year contract position will be located in Arlington, VA, Louisville, KY and/or Greensboro, NC and will require travelling extensively.
  • Must be a US Citizen and be able to obtain a Postal Sensitive Secret clearance.

  • Proactively detect instances of suspected fraud and resolve allegations that have been brought to their attention.
  • Review/analyze applicable employment and medical data maintained by DOL, Postal Service, and other related sources to gather information and evidence related to the possible loss of postal funds and/or assets within the Injury Compensation (IC) Program. The WCSS's review is limited to gathering information and evidence. WCSSs are prohibited from performing or commenting on the claims management duties of the IC specialists. Perform physical and technologically - assisted surveillances.
  • Analyze data using computer systems and software to obtain and process information for the purpose of identifying suspected loss of postal funds and/or assets within the IC Program.
  • Support full-time agents to gather information and evidence related to the possible loss of postal funds and/or assets within the IC Program and by interviewing potential witnesses.
  • Request/perform criminal history, driver's license, and/or insurance company record checks.
  • Conduct potential witness interviews, including public and private sector employees and employers, and others to secure and document information and evidence of suspected loss of postal funds and/or assets within the IC Program. Unaccompanied interaction and interviews with potential witnesses will be limited to obtaining subject background information and information in support of the WCSS's surveillance activity. WCSSs may conduct witness interviews of company’s employees at the direction of the case agent /agent but are not required to be accompanied by the agent. However, WCSSs must be accompanied by the case agent/agent when conducting formal interviews of non-company’s personnel.
  • Conduct physical and/or technologically assisted surveillance activities of suspect claimants.
  • Make detailed oral and written reports of findings to the case agent/agent. Prepare other written reports and correspondence as required.
  • Provide oral or written testimony at administrative and judicial hearings, civil, and criminal court proceedings as required.

  • 5+ years of Law Enforcement experience, including experience conducting physical and electronic surveillances and interviews.
  • Knowledge of the laws of evidence.
  • Strong analytical skills, including the ability to analyze documents and elicit factual information.
  • Strong computer skills.
  • Ability to take comprehensive notes and generate detailed technical and non-technical reports based on the notes taken.
  • Strong organizational and time management skills.
  • Good human relations skills, including the ability to communicate orally sufficient to express thoughts to a variety of people.
  • Ability to work on weekdays and during irregular and unusual hours, including evenings, late nights, weekends, and holidays, as necessary, and at the designated hourly rate, without any additional premium pay (overtime pay, compensatory time off; Sunday pay, night pay differential, and holiday premium pay).
  • Ability to travel extensively and for extended periods of time, as needed, with little or no advance notice or preparation.
  • A valid driver's license.
  • All candidates must be a US Citizen able to obtain a Postal Sensitive Secret clearance.
  • Candidate must have lived in the United States for the past 5 years.
  • Cannot have more than 6 months travel outside the United States within the last 5 years. Military Service excluded.

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