UI Audit and Fraud investigator

Found in: Talent US C2 - 1 week ago

Boston, United States Commonwealth of Massachusetts Full time

Description

The Department of Unemployment Assistance (DUA) administers the Unemployment Insurance (UI) program which provides temporary income assistance to Massachusetts workers who are unemployed through no fault of their own and who are able to work, available for work and looking for a job. 

The Compliance Officer monitors for the purpose of compliance various activities, services and/or functions related to the potential improper payment of benefits by the Department of Unemployment Assistance related to fraudulent activities by reviewing and investigating UI claim data and UI system transactions using pattern recognition database and industry risk analytics software.The incumbent identifies, reviews, and investigates data patterns and documents pertinent information concerning any potentially fraudulently claim activities or other alleged violations of laws, rules, and regulations pursuant to M.G.L 151A and 430 CMR. Flag potential suspicious accounts and claims for further investigation and assist in the cases as needed. Resolve conflicting information concerning intricately involved scenarios and cases of alleged noncompliance with laws, rules, and regulations. Conducts investigations and confers with parties; conducts interviews; prepares reports, issues determinations, and performs related work as required.

Primary program areas include specialized investigations in fictitious employers' schemes, organized fraud, stolen identities and returned bank payments. Participates in investigation of allegations of fraudulent claim filings, compromised account payments and incidents of multi-claim filing associated with fraudulent employer accounts or claimant fraudulently efforts to knowingly obtain benefits.

Duties and Responsibilities:

Reviews and analyzes advanced queries and ad hoc reports for potential incidents of Unemployment Insurance fraud and takes appropriate action towards deter and prevention of such activities. Implements procedures to be used in collecting information and evidence in connection with data audits regarding alleged fraud or other non-compliance with Massachusetts General Law, Chapter 151A and the associated agency rules, procedures and regulations. Obtains evidence to establish facts concerning alleged non-compliance with laws, rules and regulations by providing review and analysis in order to determine the extent of non-compliance or other fraudulent activities. Validate data sets and payments using fraud analytics and make appropriate findings pursuant to Chapter 151 A, 430 CMR, and agency policy as expounded in the Job Service Representatives Handbook, LO. Bulletins and other agency directives. Reviews reports, documents, complaints, and pertinent information received from reports, audits, queries, the general public, agency personnel, and other sources concerning alleged violations of laws and regulations in order to determine the appropriateness of the complaint to determine the proper action to be taken and to take that action/or to refer complaints to the appropriate agency. Responds to inquiries in order to provide information concerning agency policies and procedures and laws, rules and regulations governing agency activities related to fraudulent activities and the improper payment of UI benefits. Verifies information obtained in order to establish accuracy arid authenticity of facts. Confers with parties in order to resolve issues, make appropriate determinations and to encourage compliance with established laws, rules and regulations. Prepare and present findings to supervisor and other management in order to assist them in making appropriate recommendations. Participates in on-the-job training for new employees. Update and conduct transactions in the automated UI systems as needed related to investigations as needed.

Preferred Qualifications:

Experience with reviewing large data sets. Experience working with reporting software and spreadsheets. Knowledge of methods used to report wage record details. Knowledge of the process to obtain an Employer Account Number. Knowledge of identity theft, fictitious employer schemes and organized fraud. Knowledge of the principles, practices, and techniques of investigative procedures.

This is a temporary position associated with a funding opportunity provided by the US Department of Labor for which funding expires on 12/31/2025. This position expires on 12/31/2025.

Qualifications

First consideration will be given to those applicants that apply within the first 14 days.

Minimum Entrance Requirements: Applicants must have at least (A) three years of full-time, or equivalent part-time, experience in investigatory, law enforcement or regulatory administration work, or (B) and equivalent combination of the required experience and the substitutions below.

Substitutions:

A Bachelor's or higher degree may be substituted for a maximum of two years of the required experience.*

*Education toward such a degree will be prorated on the basis of the proportion of the requirements actually completed.

Comprehensive Benefits

When you embark on a career with the Commonwealth, you are offered an outstanding suite of employee benefits that add to the overall value of your compensation package. We take pride in providing a work experience that supports you, your loved ones, and your future.

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