KMRG, LLC Hiring for Healthcare Fraud Investigator at Lexington, KY Full Time

We are seeking an experienced Healthcare Fraud Investigator to support the U.S. Attorney’s Office (USAO) Eastern District of Kentucky (EDKY). The investigator plays a vital role in the investigation and prosecution of Affirmative Civil Enforcement (ACE) cases. Your scope of work focuses on civil healthcare fraud investigations associated with the COVID-19 pandemic.

This is a full-time opportunity in which we’ll provide competitive pay, comprehensive benefits, and job stability and security.

Apply today!

Responsibilities

• Draft legal processes for investigations (i.e., subpoenas, affidavits in support of search warrants, or discovery requests)
• Identify documentary and testimonial evidence relevant to violations of this statute
• Prepare record requests and analyze records received
• Conduct surveillance, public record research, locate and interview witnesses
• Help decide the best methods for planning, developing and conducting investigations
• Gather facts, obtain statements and explanations, learn sequences of events, and synthesize evidence
• Provide advice to attorneys on investigative and litigation steps
• Work with the ACE Assistant United States Attorneys (AUSAs) to plan and conduct ACE investigations
• Gain an understanding of all applicable federal, state, and local laws to guide investigations
• Work with AUSAs and supervisory attorneys to identify applicable laws and potential violations
• Determine necessary proof and devise methods for obtaining, preserving, and presenting evidence
• Help decide the best methods for planning and conducting investigations
• Identify resources that may be required for investigations
• Coordinate with AUSAs and any law enforcement agents to conduct witness interviews and/or surveillance
• Document interviews and or surveillance
• Conduct public record research and data analysis
• Coordinate with AUSAs to prepare written requests for information
• Analyze and categorize records produced
• Assist AUSAs with compiling and synthesizing documentary evidence and witness statements
• Prepare interim/final s on the progress of investigations (i.e., findings, conclusions, assessments, witnesses, etc.)
• Draft written s summarizing witness interviews, surveillance activities, and review of documentary evidence
• Assemble, correlate, and analyze facts obtained and prepare necessary visuals (i.e., charts, memoranda)
• Compile evidence and create summary materials for trial and court presentations
• Examine financial records (i.e., books, records, computer tapes, data processing materials etc.)

Knowledge & Skills

• Knowledge of legal and law enforcement terms and procedures (i.e., False Claims Act)
• Knowledge of investigative techniques and conducting witness interviews
• Excellent written and oral communication skills
• Knowledge of medical billing policies and procedures (preferred)

BACKGROUND

• Minimum 15 years of law enforcement investigation experience
• Experience planning, conducting, and participating in complex investigations required
• Experience in investigations of False Claims Act or healthcare fraud violations preferred

EDUCATION

• Bachelor’s degree required
• Law-related degree preferred

LOCATION

• 260 W. Vine St., Suite 300 Lexington, Kentucky 40507

TELEWORK

• N/A

CLEARANCE

• U.S. citizenship is required since this role supports the U.S. federal government

CLIENT

• Department of Justice (DOJ)

TRAVEL

• Travel within the district is required on frequent basis

WORK HOURS

• 40 hours per week
• 8 hours per day

EMPLOYMENT CLASSIFICATION

• Employment Classification Eligibility — Exempt

RELOCATION

• Not eligible for relocation benefits

KMRG, LLC is an Equal Opportunity/Affirmative Action (EEO/AA) employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex, gender identity, sexual orientation, ancestry, national origin, age, marital or civil partnership status, mental disability, physical disability, medical condition, pregnancy, maternity status, political affiliation, military or veteran status, genetic information, traits historically associated with race, or any other basis prohibited by federal, state, and/or local law.

Other Considerations. Applicants will be subject to a background investigation. Individual’s primary workstation is located in an office area. The noise level in this environment is low to moderate. Regularly required to sit for extended periods up to 100% of the time; frequently required to move about to access file cabinets and use office equipment such as PC, copier, fax, telephone, cell phone, etc. Occasionally required to reach overhead, bend, and lift objects of up to 10 lbs. Specific vision abilities required by this job include the use of computer monitor screens up to 100% of the time.

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