Investigator - Medicaid Fraud Division
State of Georgia
- Atlanta, GA
- Permanent
- Full-time
- Attach a current Resume
- Cover Letter
- Attach "Department of Law Employment Application" (click link to obtain:
- If the file is too large to attach please email the document(s) to
- Responds to assignments and requests for assistance by reviewing documentation, conducting interviews, and gathering intelligence information for health care fraud investigations and patient abuse investigations.
- Participates in the planning and gathering of information for investigations involving health care fraud and patient abuse investigations.
- Assists in executing on-site search warrants to obtain evidence of health care fraud and patient abuse. Assists in the identification and seizure of health care fraud evidence during the execution of on-site search warrants.
- May be issued firearms and/or less lethal equipment (e.g. pepper spray).*
- Assists in preparing charts, schedules, and presentations for the prosecution of health care fraud cases.
- Follows appropriate laws, guidelines, and policies in maintaining the chain of custody for evidence.
- Collects, reviews, and evaluates the necessary documents to identify and investigate health care fraud and patient abuse, including medical records, health care providers' billing records, and records.
- Assists in developing databases to analyze appropriate medical data. Enters data into databases and analyzes the data for evidence.
- Assists in conducting source and expenditure analyses and cash flow analyses of suspects in health care fraud investigations and patient abuse investigations.
- Assists in searching public records, governmental databases, and commercial databases for evidence of health care fraud and patient abuse allegations.
- Assists the appropriate parties in identifying potential assets subject to seizure due to health care provider fraud.
- Assists the appropriate parties in organizing, analyzing, and processing items of evidence and other documentation for investigation and prosecutorial purposes in health care fraud and patient abuse investigations.
- Demonstrates a basic knowledge of computer software in creating databases, spreadsheets, graphs, and presentations.
- Demonstrates the appropriate computer skills to conduct health care fraud investigations.
- Prepares thorough and accurate reports documenting interviews of witnesses and suspects in a timely manner.
- Prepares thorough and accurate reports documenting the execution of search warrants and the seizure of evidence in a timely manner.
- Prepares thorough and accurate reports documenting the analyses of financial databases and conclusions of the analyses in a timely manner.
- Prepares thorough and accurate reports documenting public record and database searches and conclusions from the searches in a timely manner.
- Prepares thorough and accurate case reports for all investigative activities in a timely manner.
- Distributes copies of reports to the appropriate parties in a timely manner.
- Provides accurate testimony concerning health care fraud investigations and patient abuse investigations.
- Demonstrates knowledge of court system operations and methods of presenting testimony.
- Coordinates and prepares courtroom testimony with the appropriate prosecuting attorney.
- Demonstrates skills to be a witness and/or evidence coordinator on behalf of the prosecuting attorneys to ensure that all evidence and witnesses are available for presentation.
- Maintains assigned equipment based on Department policy and standards. Completes applicable reports in a timely manner.
- Demonstrates skills that allow the development of relationships and liaisons with other agencies, departments, and the public.
- Participates in seminars and professional meetings when available and approved in advance.
- Maintains professional knowledge by reading up-to-date articles, books, and periodicals.
- Applies pertinent new knowledge to the performance of assigned responsibilities.
- Treats all other state and local personnel fairly, giving preferential treatment to no one.
- Communicates accurate information to all other state personnel in a professional and courteous manner that conveys a willingness to assist.
- Accepts direction and feedback from supervisors and follows through appropriately.
- Accepts responsibility for mistakes and takes action to prevent similar occurrences.
- Uses appropriate established channels of communication.
- Maintains relationships and liaisons with other agencies, departments, and the public according to Unit requirements.
- Fraud investigation or related experience.
- POST-Certification
- Criminal Justice or Business related BA degree
- Certified Fraud Examiner
- Law enforcement experience
- Demonstrated analytical skills.
- Experience with social media and digital evidence-based investigations