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Healthcare Fraud Investigator

4 months ago

Lexington, United States Ardelle Associates Full time

Ardelle Associates is seeking a Healthcare Fraud Investigator to support the Department of Justice (DOJ) Affirmative Civil Enforcement (ACE) Section of the U.S. Attorney's Office (USAO) in Lexington, KY.

The purpose of the Investigator is to develop investigative plans, prepare record requests and analyze records received in response, conduct surveillance, conduct public record research, locate and interview witnesses, gather and synthesize evidence, provide advice to attorneys on investigative and litigative steps, and perform other work pertinent to ACE’s enforcement activities, with an emphasis on civil healthcare fraud investigations associated with the COVID-19 pandemic.

DUTIES SUMMARY:

Planning and conducting investigations related to civil healthcare fraud, developing investigative plans, analyzing records, conducting surveillance, conducting public record research, locating and interviewing witnesses, gathering and synthesizing evidence, providing advice to attorneys, preparing written requests for information, preparing written reports on progress of investigations, and assisting in compiling and synthesizing documentary evidence and witness statements. ​

SKILLS & EXPERIENCE:

-Experience planning, conducting, and participating in complex investigations of False Claims Act or healthcare fraud violations is required.

-Experience in drafting legal processes for obtaining information, conducting witness interviews, and drafting written reports summarizing interviews and evidence is required.

-Excellent communication skills are required.

-Other skills: Analytical skills; Detail-Oriented; Forensic Accounting; Interview Techniques; Regulatory Compliance; Data Visualization.

QUALIFICATIONS:

-Bachelor's Degree required (Law-related degree preferred)

- Fifteen (15) years of Law Enforcement Investigation experience required

- U.S. Citizenship and ability to pass a background investigation required

- Certifications in SAS, SWL, Blockchain Analysis and/or Cybersecurity Fundamentals preferred

RESUME: Resume must include three (3) professional references and list any federal security clearances

Job Types: Full-time, Contract

Pay: $31.92 - $43.04 per hour

Expected hours: No more than 40 per week

Benefits:


  • 401(k)
  • Dental insurance
  • Health insurance
  • Mileage reimbursement
  • Paid time off
  • Travel reimbursement
  • Vision insurance


Schedule:


  • 8 hour shift
  • Monday to Friday


Education:


  • Bachelor's (Required)


Experience:


  • Law Enforcement Investigation: 10 years (Preferred)


License/Certification:


  • AHFI or CFE (Preferred)


Ability to Commute:


  • Lexington, KY 40507 (Required)


Work Location: In person