Fraud Investigator (Part Time)
Salary: $20.46 – $26.22 Hourly
Job Type: Part-time Benefit Eligible
Location: Outagamie County Government Center 320 South Walnut Street, Appleton, Wisconsin
Department: DHHS Economic Support
Reporting to the Supervisor, Economic Support, the Fraud Investigator supports program integrity by performing QA reviews, conducting the investigation and participating in the prosecution of welfare fraud cases, coordinating collection of benefit overpayments and third party liability payments, and coordinating the W-2 loan program.
The following duties are most critical for this position. These are not to be construed as exclusive or all-inclusive. Other duties may be required and assigned.
· Makes recommendations and assists staff and division management regarding fraud and collections policies and procedures. Trains staff to recognize cases that may be error prone and in interviewing techniques.
· Accepts referrals on alleged fraud activity. Gathers evidence, conducts investigative interviews, calculates overpayments, writes criminal complaints, or disqualifies recipients as appropriate.
· Completes crossmatches received from the State regarding applicants and recipients with income and assets, as assigned. Gathers information and takes appropriate action.
· Prepares evidence and witness list for District Attorney’s office.
· Makes recommendations to the District Attorney and Probation and Parole offices regarding disposition of welfare fraud cases.
· Investigates and pursues subrogation in situations where there may be third party liability for medical costs paid by the Medicaid Program.
· Performs Quality Assurance reviews on a designated sample of Economic Support cases, records and analyzes the results, and works with staff on corrective actions.
· Performs eligibility determination, change center, and screening duties.
· Develops and maintains investigation resources and a network of information-gathering sources.
· Maintains case records, workload statistics, and other associated records. Prepares reports as required.
· Completes affidavits for lost or W2 and ChildCare checks. Interviews clients, makes police contacts, etc.
· Testifies at administrative fair hearings when the fraud investigator has initiated a negative action in a case and the client requests a hearing. Testifies in court regarding cases investigated.
· Conducts front-end investigations of applicants for public assistance.
· Maintains system for collection and recording of overpaid benefits and third party liability payments.
· Establishes and monitors repayment plans for W-2 Job Access loans.
· Maintains regular and predictable attendance, works overtime/extra hours as required.
· Performs other duties assigned.
· High school graduate or GED and three to five years economic support experience or investigative experience.
· Or any combination of education and experience that provides equivalent knowledge, skills, and abilities.
Required or Preferred Skills:
· Ability to operate a variety of office equipment including personal computer, photocopier, and telephone.
· Ability to transport self to and from various locations on demand.
· Ability to add, subtract, multiply, divide, calculate decimals and percents, and make use of the principles of descriptive statistics.
· Ability to train staff on correct procedures.
· Ability to comprehend and interpret a variety of documents including fraud referrals, crossmatches, criminal complaints, disposition reports for court cases, vehicle records, credit reports, policy and procedure manuals, handbooks, etc.
· Ability to comprehend and evaluate evidence in order to detect and prove intentional fraudulent activities.
· Ability to prepare a variety of documents including statistical reports, criminal complaints, etc.
· Ability to understand and follow insurance and subrogation procedures.
· Ability to use and interpret legal terminology.
· Ability to conduct investigative interviews and communicate effectively with clients, Economic Support staff, District Attorney’s office, law enforcement agencies, child support agencies, financial institutions, employers, attorneys, insurance companies, Department of Motor Vehicle personnel, welfare agencies in other Counties and States, Probation and Parole personnel, and others verbally and in writing.
OUTAGAMIE COUNTY IS AN EQUAL OPPORTUNITY EMPLOYER. IN COMPLIANCE WITH THE AMERICANS WITH DISABILITIES ACT, THE COUNTY WILL PROVIDE REASONABLE ACCOMMODATIONS TO QUALIFIED INDIVIDUALS WITH DISABILITIES AND ENCOURAGES BOTH PROSPECTIVE EMPLOYEES AND INCUMBENTS TO DISCUSS POTENTIAL ACCOMMODATIONS WITH THE EMPLOYER.
|Job Category||Economic Support|
|Date Posted:||January 10, 2019|