- Hourly / - BiWeekly /
- Monthly / $38,988.00-$61,649.00 Yearly
A Fraud Investigator Law Department II is the full performance level of professional investigative work in the areas of medicaid fraud, and consumer protection. Employees in this class do not supervise but may provide guidance and advice to less experienced investigators.
Employees receive general supervision from the Chief Investigator. Employees in this class may be required to work on weekends and holidays as needed.
Fraud Investigator I, II and III are differentiated on the basis of the complexity of the investigations in the specific areas assigned, that is, medicaid fraud, consumer protection, and securities and the degree of supervisory control exercised by the supervisor over these employees. A Fraud Investigator I handles routine investigations of minimal complexity under moderate supervision in the areas of medicaid fraud and consumer protection. The II is the full performance level and handles investigations of greater complexity than a I but of lesser complexity than a III under general supervision in the areas of medicaid fraud and consumer protection. The III level handles highly complex and sophisticated investigations under general supervision in the areas of medicaid fraud, consumer protection and securities.
Plans and conducts investigations relatively independently or with a higher level investigator relating to cases of alleged or suspected violations of consumer laws, and suspected fraud by health care providers receiving medicaid funds, and other violations including theft, misappropriation by a fiduciary, bribery, assault, income tax violations, drug violations, conspiracy, perjury, obstruction of justice, patient abuse and neglect of individuals in health care facilities receiving payments under the State’s Medicaid program;
Interviews or interrogates all parties to such cases, including, but not limited to, corporate, banking, and small business executives, officers and employees, doctors, lawyers, State representatives, private citizens, confidential informants, patients, law enforcement personnel, medical experts, and other appropriate witnesses;
Locates, searches, recognizes, seizes, and preserves physical or documentary evidence applying all laws and legal principles so as to avoid the effect of the exclusionary rule;
Analyzes patient medical history, provider billing, and corporate records;
Develops leads and locates witnesses;
Conducts undercover surveillance;
Prepares charts and exhibits for trial;
Testifies in division or court proceedings;
Prepares and serves subpoenas or other necessary documents;
Obtains search warrants through the use of sworn affidavits;
Uses cameras and photographic equipment to record evidence and documents;
Analyzes requests, complaints and allegations to identify the issue involved and the type of evidence that will be needed in each case;
Recognizes the need for prompt reporting of critical information to other offices and agencies as the exigencies of any given situation may require;
Presents findings in clear, logical, impartial and properly documented reports;
Assists attorneys in the drafting of briefs, statement of facts, Assurances of Discontinuance, search warrants, and depositions;
Makes recommendations as to whether a case should be prosecuted or referred for civil remedies if administratively warranted;
Maintains inventory of and chain of custody of evidence;
Recommends policy or procedural changes relative to investigative and accounting/auditing techniques;
Performs fact-finding surveys for the guidance of the division in establishing policy or rule making or for recommendation of new or changed legislation;
May assist in the planning, direction and organization of all field investigations;
May direct less experienced investigative personnel, recommending investigative action or direction;
May make recommendations to division attorneys;
May, when necessary, participate in negotiations and discussions with other agencies or components concerning complex or sensitive investigative matters;
May recommend policy or procedural changes which affect division operations;
Performs other related duties.