fraud investigator

San Bernardino County

<div><div><div><h2 class="jobSectionHeader"><b>The Job</b></h2></div><br>
<p></p><div><br>
<p>The <b>Fraud Investigation Unit</b> of the <b>Human Services Program Integrity Division</b> is recruiting for Fraud Investigators who identify, investigate, and eliminate fraudulent receipt of public assistance (CalWORKS, CalFresh, etc.). This includes collecting and documenting evidence and preparing reports on findings to be used either in the prevention of fraud or in the prosecution of an individual by the District Attorney's office. <b>Active peace officers that meet the minimum requirements are encouraged to apply. San Bernardino County has reciprocity with PERS and encourages PERS employees to apply.</b></p><b><br>
Bilingual Compensation: </b>Candidates with bilingual skills (Spanish/English) are encouraged to apply. Applicants must pass a language competency examination in order to receive bilingual compensation.<br>
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For more detailed information, refer to the Fraud Investigator job description.<p><b><br>
EXCELLENT BENEFITS</b></p><p>
To review job-specific benefits, refer to:<br>
Summary of Benefits<br>
Memoranda of Understanding (MOU)</p><p><b><br>
CONDITIONS OF EMPLOYMENT</b></p><p>
Fraud Investigators are Peace Officers [P.C. 830.35(a)] and are authorized to carry a firearm.<br>
<br>
<b>Fraud Investigators must:</b></p><p><b>
(1)</b> Be at least 21 years of age and a citizen of the United States or a legal resident who has applied for citizenship.<br>
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<b>(2)</b> Possess a high school diploma or GED equivalent.<br>
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<b>(3) </b>Be fingerprinted and pass a background investigation, medical examination and psychological evaluation - candidates must <b>NOT</b> have been convicted of a felony.<br>
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<b>(4)</b> Possess a current, unexpired, California Basic POST Certificate or higher.</p><p><b>
License:</b> Travel throughout the County is required. A valid California Class C driver license is required at the time of appointment and must be maintained for the individual providing the transportation. Employees may be required to use personal vehicles and show proof of automobile liability insurance.</p><b>
Sponsorship:</b> San Bernardino County is not able to consider candidates who will require visa sponsorship at the time of application or in the future.</div><p></p>
<div><h2 class="jobSectionHeader"><b>Minimum Requirements</b></h2></div>
<p></p><div><p><b>Certificate:</b> Must possess a <b>current</b>, <b>unexpired,</b> California POST Basic, Intermediate, or Advanced Certificate.</p><p><b><i>
Note:</i></b><i> Candidate must attach a high-quality copy of their </i><b><i>current</i></b><i>, </i><b><i>unexpired,</i></b><i> California POST Basic, Intermediate, or Advanced Certification (and Requalification Certificate, if applicable).</i><br>
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<b>-AND-</b><br>
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<b>Experience</b><b> (Applicants must meet </b><b>one</b><b> of the following options):</b><br>
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<b>Option 1:</b> One (1) year of experience as a <b>criminal investigator </b>with sworn peace officer status. Experience should include primary responsibility for full-time follow-up criminal investigations in a law enforcement agency. <b><i>Note:</i></b><i> Traffic investigations and Correctional Facility investigations are not considered qualifying experience.</i></p><p><b>
Option 2: </b>Two (2) years of <b>law enforcement patrol </b>experience with sworn peace officer status enforcing the general criminal laws of the State.</p></div><p></p>
<div><h2 class="jobSectionHeader"><b>Desired Qualifications</b></h2></div>
<div><p>A completed degree in Administration of Justice or Behavioral/Social Science is highly desirable.</p></div>
<div><h2 class="jobSectionHeader"><b>Selection Process</b></h2></div>
<p></p><div><div><b>Application Procedure:</b>Complete and submit the online employment application and supplemental questionnaire by 5:00 PM on the filing deadline. <i>Resumes will not be accepted in lieu of the application and/or supplemental questionnaires.</i><br>
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Completing your application with statements such as &quot;see/refer to resume&quot; or &quot;see attached&quot; rather than completing your work experience section of your application may affect your eligibility or competitive evaluation score.<br>
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<b>Evaluation Procedure:</b><br>
There will be a <b>competitive evaluation </b>of qualifications based on a review of the Application and Supplemental Questionnaire <b>only</b> and resumes will not be reviewed. It is to your advantage to provide as much relevant and detailed work experience as possible in <b>both</b><b> </b>your work experience and supplemental questionnaire.<br>
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To ensure timely and successful submission of your online application, please allow ample time to complete and submit your application before the posted filing deadline. Applicants will be automatically logged-out if they have not submitted the application and all required materials prior to the posted deadline. Once your application has been successfully submitted you will receive an onscreen confirmation and an email. We recommend that you save and/or print these for your records. <i>Please note, if you do not receive an onscreen confirmation and an email acknowledging our receipt of your application we have not received your application.</i><p><b><br>
Additional Information and Resources:</b><br>
If you need <b>technical assistance</b>, review the Government Jobs online application guide or contact their Toll-Free Applicant Support line at <b>(855) 524-5627</b>. Please note that Human Resources is not responsible for any issues or delays caused by your internet connection, computer, or browser when submitting an application.</p><p><b>
Equal Employment Opportunity (EEO) / Americans with Disabilities Act (ADA): </b>San Bernardino County is an Equal Employment Opportunity (EEO) and Americans with Disabilities Act (ADA) compliant employer, dedicated to ensuring equal employment opportunities for all employees and applicants.</p><p><b>
ADA Accommodation: </b>If you have a disability and need accommodations during the testing process, please submit the Special Testing Accommodations Request Form (Download PDF) within one week of the recruitment filing deadline.</p><p><b>
Veterans' Preference: </b>Eligible veterans and their spouses or widows/widowers who are not current County employees may receive additional Veterans' Preference points. For details and instructions on how to request these points, please refer to the Veterans' Preference Policy .</p><p><b>
For more important details, </b><b>review the Applicant Information and County Employment Process</b></p></div></div></div></div><p></p>

Fraud Investigator

Peraton

<div><div><h5 class="jobSectionHeader"><b>ABOUT PERATON</b></h5><p>
Peraton is a next-generation national security company that drives missions of consequence spanning the globe and extending to the farthest reaches of the galaxy. As the world&rsquo;s leading mission capability integrator and transformative enterprise IT provider, we deliver trusted, highly differentiated solutions and technologies to protect our nation and allies. Peraton operates at the critical nexus between traditional and nontraditional threats across all domains: land, sea, space, air, and cyberspace. The company serves as a valued partner to essential government agencies and supports every branch of the U.S. armed forces. Each day, our employees solve the most daunting challenges that our customers face. Visit peraton.com to learn how we&rsquo;re keeping people around the world safe and secure.</p></div><div><h5 class="jobSectionHeader"><b>
PROGRAM OVERVIEW</b></h5><div>
Performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse in Medicare and Medicaid programs.</div></div><div><h5 class="jobSectionHeader"><b>
ABOUT THE ROLE</b></h5><div><div>
SafeGuard Services (SGS), a subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse.</div><div><b>
We are looking to add a Fraud Investigator to our SGS team of talented professionals.</b></div><div></div><div><b><br>
What you'll do:</b></div><div></div><div><br>
The position is expected to perform high level complex investigations of medical professional service providers and develop cases for future action, including referral to law enforcement, education, over payment recovery and other administrative actions. Will work with internal resources and external agencies to develop cases and corrective actions as well as respond to requests for data and support.</div><div><br>
</div><ul><li>An investigator uses good judgment and may work independently with minimum supervision and direction.
</li><li>The investigator also may work as part of a team as there may be times when the investigator needs to work with state and/or federal investigators and other personnel.
</li><li>An investigator handles multiple caseload assignments concurrently; organizes and analyzes complex evidentiary patterns; interviews and obtains statements from witnesses and others.</li><li>
Investigators may also be required to complete complex investigative reports that apply regulations or rules to the program(s) affected by the behavior being investigated. There may also be times when the investigator will need to apply federal or state laws.
</li><li>Investigators are expected to research and understand the relevant offenses being investigated; conduct efficient and effective investigations concerning those alleged offenses and detect or verify suspected violations; obtain information and evidence by observation, record examination, and interview.
</li><li>Investigators then analyze the results of the investigation to ascertain if the allegations have been corroborated and work with others to determine the appropriate steps that need to be taken to address the issues.
</li><li>As part of an investigation, the investigator will need to prepare correspondence; be objective and accurate and communicate with others with tact.
</li><li>There may be times when investigators need to react to unplanned situations, be flexible in planning their activities and adopt effective courses of action.
</li><li>As investigators will be working with health privacy information, they also must maintain confidentiality and understand all the laws, rules and regulations concerning health privacy.</li><li>
Telework available from Florida (preferred) and Georgia</li></ul></div></div><div><h5 class="jobSectionHeader"><b>
QUALIFICATIONS</b></h5><div><div><b>
Basic Qualifications:</b></div><ul><li>
5 years with BS/BA; 3 years with MS/MA; 0 years with PhD</li><li>
Investigative experience</li><li>
Strong investigative skills</li><li>
Strong communication and organization skills</li><li>
Strong PC knowledge and skills</li><li>
U.S. citizenship required</li><li>
Must reside in Florida (preferred) and Georgia.This is a fully remote position.</li></ul><div><b>
Desirable Qualifications:</b></div><div><b>
The most competitive candidates will have:</b></div><ul><li>
Strong background in investigations.</li><li>
Experience in reviewing claims for technical requirements, performing medical review, and/or developing fraud cases</li><li>
Knowledge of investigative practices regarding healthcare providers.</li><li>
Knowledge of Medicare and/or Medicaid programs and the rules, regulations, policies and procedures</li><li>
Background in evaluating, reviewing and analyzing medical claims and records</li><li>
Ability to learn and operate a variety of data systems, equipment and tools used in investigations</li><li><div>
Bilingual with ability to speak, read and write English and Spanish (Preferred)</div></li></ul><div><b>
Essential Functions:</b></div><ul><li>
This position may require the incumbent to appear in court to testify about work findings.</li><li>
Ability to perform research and draw conclusions</li><li>
Ability to present issues of concern, citing regulatory violations, alleging schemes or scams to defraud the Government</li><li>
Ability to organize a case file, accurately and thoroughly document all steps taken</li><li>
Ability to compose correspondence, reports and referral summary letters</li><li>
Ability to educate providers, provider associations, law enforcement, other contractors and beneficiary advocacy groups on program safeguard matters</li><li>
Ability to communicate effectively, internally and externally</li><li>
Ability to interpret laws and regulations</li><li>
Ability to handle confidential material.</li><li>
Ability to report work activity on a timely basis.</li><li>
Ability to work independently and as a member of a team to deliver high quality work</li><li>
Ability to attend meetings, training, and conferences, overnight travel required<b>.</b></li></ul></div></div><div><h5 class="jobSectionHeader"><b>
DETAILS</b></h5><div><p>
<b>Target Salary Range:</b> $66,000 - $106,000. This represents the typical salary range for this position. Salary is determined by various factors, including but not limited to, the scope and responsibilities of the position, the individual&rsquo;s experience, education, knowledge, skills, and competencies, as well as geographic location and business and contract considerations. Depending on the position, employees may be eligible for overtime, shift differential, and a discretionary bonus in addition to base pay.
</p></div><div><p>
<b>Benefits Statement:</b> Peraton offers eligible employees a variety of benefits including medical, dental, vision, life, health savings account, short/long term disability, EAP, parental leave, 401(k), paid time off (PTO) for vacation, and company paid holidays. A full listing of available benefits can be viewed at https://www.careers.peraton.com/benefits.
</p></div><div><p>
<b>Application Statement:</b> The application period for the job is estimated to be 30 days from the job posting date. However, this timeline may be shortened or extended depending on business needs and the availability of qualified candidates.
</p></div><p><b>
EEO:</b> Equal opportunity employer, including disability and protected veterans, or other characteristics protected by law.</p></div></div><div></div>

FRAUD INVESTIGATOR - MEDICARE

Glacier Bancorp

<div><b>About The Role</b><div><b><br>
Summary</b></div><div>
The Fraud Investigator is responsible for conducting thorough investigations into suspected fraud and financial crimes, ensuring effective prevention, detection, and resolution of fraudulent activity. This role involves handling cases related to electronic banking fraud (including Zelle), new account abuse, deposit fraud, check forgery, elder abuse, debit and credit card fraud, suspected money laundering, check kiting, identity theft, internal fraud, loan fraud, and other complex schemes. This includes presenting cases to law enforcement for criminal prosecution.</div><div><br>
</div><div><b>This is a Corporate position which may be located at an available bank division location across our nine-state footprint in AZ, CO, ID, MT, NV, TX, UT, WA, or WY. The entry rate for this position is $29.23 + / per hour (calculated for Kalispell, MT). </b><b>Click here to learn more about our bank divisions.</b></div><div></div><div><b><br>
All compensation offers are analyzed individually and take into consideration multiple factors including but not limited to geographic location, years of experience, and educational background.</b></div><div></div><div><b><br>
WA Applicants ONLY range:
</b></div><div><b>Spokane $32.65 to $48.97 an hour</b></div><div><b>
Wenatchee $33.10 to $49.66 an hour</b></div><div></div><div><b><br>
Description</b></div><ul><li>
Conduct routine investigations into suspected fraud including identity theft, account abuse, check fraud, elder abuse, debit/credit card fraud, loan fraud, electronic banking fraud (e.g., Zelle), internal fraud, loan fraud, and others. Analyze transaction data and account behavior across all payment channels to detect suspicious activity and initiate appropriate investigative actions. Utilize investigative tools and techniques to gather evidence through interviews, document reviews, and transaction analysis. Refer complex cases to the Fraud Investigator Team Lead, Fraud Manager, BSA/AML team, or law enforcement as appropriate.</li><li>
Prepare detailed reports documenting findings that may be used for internal decisions or criminal prosecution. May require courtroom testimony. Document and evaluate investigative outcomes to support fraud trending, reporting, and continuous improvement of fraud prevention/investigation strategies.</li><li>
Perform fraud mitigation activities such as system monitoring, fraud recovery outreach, and applying precautionary measures (e.g., pay/no pay decisions, account holds/blocks) to protect the bank and its customers. Assist in evaluating risk factors during account opening or review processes, including recommending denial or closure of accounts based on suspicious activity.</li><li>
Utilize fraud detection program to review suspect items as needed. Communicate with internal and external stakeholders, including customers, financial institutions, and law enforcement, to verify transaction authenticity and educate on fraud risks and online banking safety.</li><li>
Maintain favorable customer relations by communicating and interacting over the phone, in writing, or in person. Collaborate regularly with bank divisions, law enforcement, and judicial agencies to support investigations and ensure timely resolution of fraud incidents. Customer relations may include both customers and non customers. Educate customers about fraud issues including online banking safety and take appropriate action to protect customers&rsquo; accounts.</li><li>
Must comply with all company policies and procedures and all applicable laws and regulations, including but not limited to, the Bank Secrecy Act, the Patriot Act, and the Office of Foreign Assets Control. Must complete the assigned online training courses and achieve a passing score by due date.</li></ul>
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<b>About You</b><div><div><div><b><br>
Qualifications</b><br>
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</div></div><div><div><div><div><b><br>
Education</b></div></div><div><div><div><div><b><br>
Required/Preferred</b></div><div><b><br>
Education Level</b></div><div><b><br>
Description</b></div></div><div><div><br>
Required</div><div><br>
Bachelor&rsquo;s Degree</div><div><br>
Bachelor's degree in business, finance, accounting, criminal justice, law or related field.</div></div></div></div></div></div><div><div><div><div><b><br>
Experience</b></div></div><div><div><div><div><b><br>
Required/Preferred</b></div><div><b><br>
Experience Level</b></div><div><b><br>
Description</b></div></div><div><div><br>
Required</div><div><br>
3 years</div><div><br>
Banking operations, Fraud, AML, BSA or law enforcement investigation experience, focused on fraud investigations.</div></div><div><div><br>
Required</div><div><br>
Advanced / Specialized Knowledge</div><div><br>
Conducting professional interviews with individuals in regards to fraud investigations.</div></div><div><div><br>
Required</div><div><br>
Knowledge Of</div><div><br>
Local, state and federal laws and regulations concerning civil and criminal remedies for fraudulent check and debit card activities.</div></div><div><div><br>
Preferred</div><div><br>
Advanced / Specialized Knowledge</div><div><br>
Banking and fraud threats, along with fraud analytics including the ability to spot financial irregularities or abuse, and completed fraud investigations.</div></div><div><div><br>
Preferred</div><div><br>
Advanced / Specialized Knowledge</div><div><br>
Working with law enforcement, creating case files that can lead to prosecution and/or asset recovery.</div></div></div></div></div></div><div><div><div><div><b><br>
Would an equivalent combination of relevant education and work experience be considered?: </b>Yes</div></div></div></div><div><div><div><div><b><br>
License/Certification</b></div></div><div><div><div><b><br>
Required/Preferred</b></div><div><b><br>
License/Certification</b></div><div><b><br>
Description</b></div></div></div></div></div><div><div><div><div><b><br>
Required Skills and Abilities</b></div></div><div><br>
<ul><li>
A significant level of trust, credibility and diplomacy is required. In-depth dialogues, conversations and explanations with customers, direct and indirect reports and outside vendors can be of a sensitive and/or highly confidential nature. Communications may involve motivating, influencing, educating and/or advising others on matters of significance.</li><li>
Able to learn and retain knowledge in depth for all debit card and ATM adjustment functions; to follow Visa and ATM network and customer privacy regulations and to limit potential liability for the organization.</li><li>
Strong organizational, time management and multi-tasking skills to pivot as priorities change.</li><li>
Possess analytical and technical skills in fast-paced, changing professional environments.</li><li>
Well- developed customer relations skills.</li><li>
Must be able to maintain confidentiality.</li><li>
Strong interpersonal, verbal and written communication skills.</li><li>
Employee must be capable of interacting calmly and professionally with a variety of people from diverse backgrounds at various levels within and outside of the organization.</li><li>
Employee must be able to work and interact in a remote environment.</li><li>
Employee must be capable of regular, reliable, and timely attendance.</li></ul></div></div></div></div><div></div><div><div><div><b><br>
Additional Requirements</b></div></div><div><div><div><div><b><br>
Travel</b></div></div><div><div><div><br>
Occasional travel required: (less than 10 days per year) by automobile (as driver and passenger), commercial airlines, rental vehicles and public transportation and be able to lodge in public facilities.</div></div></div></div></div><div><div><div><div><b><br>
Working Conditions</b></div></div><div><div><div><div><b><br>
Environment: </b>Indoors, a climate-controlled shared work area.</div></div><div><div><b><br>
Noise Level: </b>Moderate noise; not extreme or excessive; within reasonable limits.</div></div><div><div><b><br>
Lifting: </b>Sedentary work: Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.</div></div></div></div></div></div><div><div><div><div><b><br>
Vision</b></div></div><div><div><div><br>
Close visual acuity to prepare and analyze data and figures, view a computer terminal, and read the computer screen, printed materials, and handwritten materials.</div></div></div></div></div><div><div><div><div><div><b><br>
Physical Activities</b></div><div><b><br>
Frequency</b></div></div><div><div><br>
Balancing: Maintaining body equilibrium to prevent falling and walking, standing or crouching on narrow, slippery, or erratically moving surfaces.</div><div><br>
Infrequent &ndash; rare.</div></div><div><div><br>
Climbing: Ascending or descending ladders, stairs, scaffolding, ramps, poles and the like, using feet and legs and/or hands and arms.</div><div><br>
Infrequent &ndash; rare.</div></div><div><div><br>
Crawling: Moving about on hands and knees or hands and feet.</div><div><br>
Infrequent &ndash; rare.</div></div><div><div><br>
Crouching: Bending the body downward and forward by bending leg and spine.</div><div><br>
Infrequent &ndash; rare.</div></div><div><div><br>
Feeling: Perceiving attributes of objects such as size and shape, temperature or texture by touching with skin, particularly that of the fingertips.</div><div><br>
Infrequent &ndash; rare.</div></div><div><div><br>
Fingering: Picking, pinching, typing or otherwise working primarily with fingers rather than with the whole hand as in handling.</div><div><br>
Daily.</div></div><div><div><br>
Grasping: Applying pressure to an object with the fingers and palm.</div><div><br>
Infrequent &ndash; rare.</div></div><div><div><br>
Kneeling: Bending legs at knee to come to a rest on knee or knees.</div><div><br>
Infrequent &ndash; rare.</div></div><div><div><br>
Lifting: Raising objects from a lower to a higher position or moving objects horizontally from position to position.</div><div><br>
Infrequent &ndash; rare.</div></div><div><div><br>
Pushing: Using upper extremities to press against something with steady force in order to thrust forward, downward or outward.</div><div><br>
Infrequent &ndash; rare.</div></div><div><div><br>
Pulling: Using upper extremities to exert force in order to draw, haul or tug objects in a sustained motion.</div><div><br>
Infrequent &ndash; rare.</div></div><div><div><br>
Repetitive Motion: Making substantial movements (motions) of the wrists, hands, and/or fingers.</div><div><br>
Daily.</div></div><div><div><br>
Stooping: Bending body downward and forward by bending spine at the waist.</div><div><br>
Infrequent &ndash; rare.</div></div></div></div></div></div><br>
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<b>What We Offer</b><div><b><br>
COMPENSATION &amp; BENEFITS:</b> Starting salary is dependent upon relevant experience and may vary based on the geographic location of the position. We offer an extensive benefits package that includes, but is not limited to medical, dental, vision, and life insurance. Coverage is available to employees and their eligible dependents in accordance with our written plan documents. You may also be eligible for a health savings account option, an Employee Assistance Program (EAP), a health rewards program, a retirement savings plan, including 401(k) and Profit-Sharing plans, short and long-term disability benefits, education and training benefits, and discounts on banking products and services. We also offer a generous Paid Time Off (PTO) plan and paid holidays. PTO accruals begin at .0745 per hour worked for our part time employees up to a maximum accrual of 240 hours per year for certain Full-Time employees. PTO accruals are dependent on position, status (Full time or Part time), and years of experience in accordance with our PTO policy. Most Full-Time employees are also offered 6 paid holidays and Part Time employees are offered pro-rated paid holidays. In addition, employees in Utah and Nevada may be eligible for pay for certain state recognized holidays. Visit our website for more details. Check it out!</div><div></div><div><b><i><br>
We are an Equal Opportunity Employer and qualified applicants, or employees will receive consideration for employment without regard to race, color, religion, national origin, sex (including pregnancy), sexual orientation, gender identity, mental or physical disability, genetic information, protected veteran status, or any other category protected by applicable federal, state, or local laws.</i></b></div><div></div><div><b><i><br>
Glacier Bancorp, Inc. does not sponsor applicants for work visas. All applicants must be legally authorized to work in the US.</i></b></div><div></div><div><b><i><br>
No Recruiters or unsolicited agency referrals please.</i></b></div></div>

Corporate Fraud Investigator

County of Santa Clara

<div><div><div><h2 class="jobSectionHeader"><b>Description</b></h2></div>
<p></p><div><div><p>Under general supervision, to investigate cases related to suspected fraudulent receipt of public assistance; to interview witnesses, conduct computer checks and analyze welfare data; and to serve civil papers and criminal complaints.</p><b>
This position is in the Social Services Agency, Special Investigations Unit. Candidates must possess a valid Specialized Investigator Basic Certificate or Basic Peace Officer Standards and Training (P.O.S.T.) Certificate, and, must be able to pass a criminal background check, polygraph, medical and psychological testing.</b></div></div><p></p>
<div><h2 class="jobSectionHeader"><b>Typical Tasks</b></h2></div>
<p></p><div><ul><li>Reviews, gathers, evaluates and analyzes evidence and information relating to the investigation of suspected welfare or IHSS fraud;
</li><li>Conducts confidential criminal history checks and other computer checks through local and state databases; analyzes data;
</li><li>Contacts other agencies, business organization, employers and other parties to secure, preserve and verify information, written statements and evidence;
</li><li>Interviews complainants, witnesses, suspects, and recipients of aid;
</li><li>Maintains thorough and accurate case summary notes;
</li><li>Evaluates information obtained and makes recommendations as to the need for prosecution;
</li><li>Assembles and reports data to enable the District Attorney to act;
</li><li>Files criminal complaints, serves subpoenas;
</li><li>Identifies over-payments and refers to collections;
</li><li>Responds to inquiries from agency and outside parties concerning related legal matters;
</li><li>Works jointly with other agencies in the development of evidence;
</li><li>Appears as a witness in court or at administrative hearings;
</li><li>Compiles, safeguards, and presents evidence for prosecution;
</li><li>Prepares oral and written reports;
</li><li>Uses work-related equipment as required;
</li><li>May detain and arrest suspects, assuring proper cause;
</li><li>Interprets, explains and applies provisions of laws, rules and regulations related to welfare or IHSS fraud;
</li><li>Provides technical assistance to lower level staff;
</li><li>May be assigned as a Disaster Service Worker, as required;
</li><li>Performs related work as required.</li></ul></div><p></p>
<div><h2 class="jobSectionHeader"><b>Employment Standards</b></h2></div>
<p></p><div><div>Sufficient education and experience which directly demonstrates the possession and application of the following knowledge and abilities:<br>
<br>
<b>Training and Experience Note: </b>The knowledge and abilities listed below are acquired through the following:<br>
<br>
Completion of 60 semester units<br>
<div>
AND</div><br>
Two (2) years performing welfare fraud investigations or investigative work in law enforcement<br>
<div>
OR</div><br>
Two (2) years as an Investigator Assistant in Santa Clara County.<br>
<br>
Possession of a valid Specialized Investigator Basic Certificate or Basic (or higher) Peace Officers Standard Training (P.O.S.T.) Certificate issued by the California Commission on Peace Officer Standards and Training (P.O.S.T.) prior to appointment.<br>
<br>
Possession of a valid California Driver's License prior to appointment and the ability to qualify and maintain a County's driver's permit.<br>
<br>
Specialization in law enforcement or related field, from an accredited university or college is desirable.<br>
<br>
<b>Special Requirements:</b><div>
<ul><li>Applicants who have passed their 20th birthday may submit an application but cannot be appointed until they have reached their 21st birthday.
</li><li>Felony convictions will be disqualifying. Misdemeanor convictions may be disqualifying depending on the type, frequency, severity and time of offense.
</li><li>Must be able to take and pass a thorough medical examination. May be disqualified on the basis of established medical standards (current P.O.S.T. or Departmental orders).
</li><li>Must successfully pass a psychological evaluation.
</li><li>Must successfully demonstrate and maintain physical fitness in order to perform the full scope and functions of the job.
</li><li>Must pass a complete background investigation including fingerprints and a search of local, state, and national files for criminal history.
</li><li>Must be a citizen of the United States or a permanent resident who is eligible for and has applied for citizenship.</li></ul></div><b>
Knowledge of:</b><ul>
<li>Modern principles and techniques of investigation, particularly as they apply to suspected fraudulent application for and receipt of public assistance;
</li><li>Principles and techniques of interviewing and interrogation;
</li><li>Rules of evidence and of court procedure;
</li><li>Methods of identifying, preserving and presenting evidence;
</li><li>Laws of arrest, search and seizure, service of legal process and the legal rights of citizens;
</li><li>Penal, Civil, Welfare and Institutions Codes, and related laws and regulations;
</li><li>Arrest techniques;
</li><li>Personal computers and common office applications;
</li><li>Methods of report preparation, writing and presentation.</li></ul><b>
Ability to:</b><ul>
<li>Interpret and effectively apply provisions of laws applicable to investigations related to suspected welfare and IHSS fraud;
</li><li>Work independently in conducting fraud investigations;
</li><li>Prepare and present clear, concise and comprehensive reports and correspondence;
</li><li>Interview effectively and secure the cooperation of others;
</li><li>Prepare and present accurate evidence, including appearing in court to give testimony;
</li><li>Communicate effectively, orally and in writing;
</li><li>Work required hours and assigned shifts;
</li><li>Use logic in making decisions and exercise sound judgment.</li></ul></div></div></div></div><p></p>

Welfare Fraud Investigator

State of Indiana

<p></p><div><div><div><div><div><b>Date Posted: </b>Apr 28, 2026
</div></div></div></div><div><div><div><div><b>Requisition ID: </b>476757
</div></div></div></div><div><div><div><div><b>Location:
</b>Indianapolis, IN, US, 46204<br>
</div></div></div></div><div></div><div><div><div><div><div><b>Work for Indiana</b></div><div></div><div><div><br>
Begin a fulfilling career with the State of Indiana by joining one of the largest employers in the state, offering a range of opportunities across 60+ agencies. At the state, you'll find competitive compensation, a robust benefits package and a commitment to work-life balance. Most importantly, you'll have the chance to make a real and measurable impact on the lives of Hoosiers across Indiana.</div></div><div></div><div><b><br>
About the Indiana Department of Workforce Development (DWD):</b><br>
Our mission is to develop a premier workforce that will allow Indiana employers to flourish and entice businesses from outside our state to relocate to Indiana. Everyone at DWD will be required to think outside-the-box; to determine metrics that will allow for measurement and improvement and efficiencies to be made along the way. Cutting edge technologies will be utilized to help assess Indiana&rsquo;s employment future. If managed properly, Indiana&rsquo;s workforce will be second to none and completely prepared for the next phase of the state and country&rsquo;s economic growth.</div><div><b><br>
Salary Statement</b>:</div><div>
The salary for this position traditionally starts at $47,320.00 but may be commensurate with education or work experience.</div><div></div><div><div><div><div><b><br>
A Day in the Life:</b></div>
</div><div><div>
The essential functions of this role are as follows:</div><ul><li>
Detect, investigate, and document cases of improperly or fraudulently claimed unemployment benefits.</li><li>
Explain complex federal and state laws, procedures and various unemployment programs to claimants, employers and other local, state and federal agencies in easily understood terms.</li><li>
Collect and weigh information and evidence collected to make a fraud determination and collection.</li><li>
Recognize eligibility issues and apply proper state and federal statutes, administrative rules, case law, policies and written guidelines to make fraud determinations.</li><li>
Prepare accurate investigative reports.</li><li>
Accurately enter and apply penalties into a computer system to ensure proper determinations are sent.</li><li>
Conduct investigative interviews with individuals being investigated. This may require travel to the local offices, locations more convenient to the claimant or county jails.</li><li>
Act as an expert witness in administrative law hearings, U.S. Federal Bankruptcy hearings or in criminal court prosecutions.</li><li>
Essential functions of this position require travel on most workdays to inspect, audit, examine, survey, or investigate clients, customers, or other regulated entities and write reports at those sites or employee&rsquo;s home. Employee reports to the agency&rsquo;s office for occasional meetings or events. Number and timing of work hours may vary daily or weekly to accommodate operational needs and staffing concerns at the client&rsquo;s or customer&rsquo;s worksite, minimize expenditures for repeated visits to complete the work, and allocate resources to complete assigned work effectively.</li></ul><div>
The job profile is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Other duties, responsibilities and activities may change or be assigned at any time with or without notice.</div></div></div><div><div><div><b>
What You'll Need for Success:</b></div>
</div><div><div>
Individuals in this role should minimally be able to articulate or demonstrate the following:</div><ul><li>
Successfully complete the Fraud Investigator training program.</li><li>
Be willing to travel with reasonable accommodation.</li><li>
The ability to be organized and have attention to detail.</li><li>
The ability to compute complicated payroll procedures and basic mathematical functions.</li><li>
The ability to partner with local, State and Federal law enforcement agencies and prosecutors.</li><li>
The ability to work well under pressure and able to always maintain a professional disposition.</li><li>
A broad knowledge of the UI system, laws, and policies necessary to discover and investigate potentially fraudulent activity.</li><li>
Knowledge of how to conduct interviews that display good communication skills under unfavorable and adverse conditions.</li><li>
Must have a High School Diploma or a High School Equivalent (HSE).</li></ul><div><b>
A degree is not required. However, a High School Diploma or High School Equivalent (HSE) and experience applying the outlined knowledge, skills, and abilities in a similar role may be considered.</b></div><div>
Individuals should have the ability to perform essential functions with or without reasonable accommodation.</div></div></div><div><div><div><b>
Supervisory Responsibilities/Direct Reports:</b></div>
</div><div><div>This role may be utilized in a supervisory capacity based on agency needs.</div></div></div></div><div></div><div><b><br>
Benefits of Employment with the State of Indiana:</b></div><div>
The State of Indiana offers a comprehensive benefit package for full-time employees which includes:</div><ul><li>
Three (3) medical plan options (including RX coverage) as well as vision and dental plans</li><li>
Wellness Rewards Program: Complete wellness activities to earn gift card rewards</li><li>
Health savings account, which includes bi-weekly state contribution</li><li>
Deferred compensation 457(b) account (similar to 401(k) plan) with employer match</li><li>
Two (2) fully-funded pension plan options</li><li>
A robust, comprehensive program of leave policies covering a variety of employee needs, including but not limited to:<ul><li>
150 hours of paid New Parent Leave and up to eight weeks of paid Childbirth Recovery Leave for eligible mothers</li><li>
Up to 15 hours of paid community service leave</li></ul></li><li>
Combined 180 hours of paid vacation, personal, and sick leave time off</li><li>
12 paid holidays, 14 on election years</li><li>
Education Reimbursement Program</li><li>
Group life insurance</li><li>
Referral Bonus program</li><li>
Employee assistance program that allows for covered behavioral health visits</li><li>
Qualified employer for the Public Service Loan Forgiveness Program</li><li>
Free Parking for most positions</li><li>
Free LinkedIn Learning access</li></ul><div></div><div><b><br>
Equal Employment Opportunity:</b></div><div>
The State of Indiana is an Equal Opportunity Employer and is committed to recruiting, selecting, developing, and promoting employees based on individual ability and job performance. Reasonable accommodations may be available to enable individuals with disabilities to complete the application and interview process as well as perform the essential functions of a role. If you require reasonable accommodations to complete this application, you can request assistance by contacting the Indiana State Personnel Department at jobs@spd.IN.gov.</div></div></div></div></div></div><p></p>

UI Fraud Investigator

South Plains Community Action Association

<div><div><div><p>Position Overview</p>
<p>South Plains Community Action Association (SPCAA) is seeking a detail-oriented and highly ethical Fraud Investigator to support the integrity of our Child Care Services (CCS) program. This role is responsible for investigating allegations of fraud, waste, and abuse involving program participants and childcare providers while ensuring compliance with Texas Workforce Commission (TWC) and federal CCDF regulations.</p>
<p>This position operates independently from eligibility and case management functions to ensure unbiased investigative outcomes.</p>
<p><b>Key Responsibilities</b></p>
<ul><li>Conduct investigations related to fraud, waste, and abuse</li>
<li>Review financial, eligibility, and attendance documentation</li>
<li>Interview clients, providers, employers, and third parties</li>
<li>Document findings and maintain cases in PIRTS</li>
<li>Prepare investigative reports and support enforcement actions</li>
<li>Conduct onsite and unannounced provider visits</li>
<li>Support audits, monitoring reviews, and improper payment recovery</li>
</ul>
<p><b>Minimum Qualifications (Screening Requirements)</b></p>
<ul><li>Associate&rsquo;s degree required in Criminal Justice, Public Administration, Social Services, or related field</li>
<li>3&ndash;5 years of experience in:</li>
<li>Fraud investigation, OR</li>
<li>Compliance, auditing, OR</li>
<li>Public benefits/program integrity</li>
<li>Valid Texas Driver&rsquo;s License</li>
<li>Ability to pass background check and complete required fraud/PIRTS training</li>
</ul>
<p><b>Preferred Qualifications</b></p>
<ul><li>Experience with TWC programs or public assistance programs</li>
<li>Knowledge of fraud detection tools and investigative techniques</li>
<li>Experience conducting interviews and writing investigative reports</li>
</ul>
<p><b>Key Skills</b></p>
<ul><li>Strong analytical and investigative skills</li>
<li>Ability to interpret policy and apply regulations</li>
<li>Excellent written documentation and reporting skills</li>
<li>High level of confidentiality and ethical standards</li>
</ul>
<p><b>Work Environment</b></p>
<ul><li>Office-based position (not remote)</li>
<li>Regional travel required, including field investigations</li>
<li>Occasional non-traditional hours for investigations</li>
</ul>
<p>Why Join SPCAA?</p>
<p>Join a mission-driven organization committed to program integrity, accountability, and serving families across the South Plains region.</p></div>
</div><div>Job Location
<div>Lubbock, Tx</div></div></div>

Child Care Services Fraud Investigator

Workforce Solutions Borderplex

<div><div><div><div><div><div><h2 class="jobSectionHeader"><b>Job Title:</b></h2><p><br>
Child Care Services Fraud Investigator</p><h2 class="jobSectionHeader"><b><br>
 Job Family:</b></h2><p><br>
Programs</p></div><div><h2 class="jobSectionHeader"><b><br>
Department/Group:</b></h2><p><br>
Family Services</p><h2 class="jobSectionHeader"><b><br>
Job Code/ Req#:</b></h2><p><br>
B18/1353</p></div><div><h2 class="jobSectionHeader"><b><br>
Location:</b></h2><p><br>
El Paso, TX</p><h2 class="jobSectionHeader"><b><br>
Travel Required:</b></h2><p><br>
Some travel in WSB region (West Texas) and state.</p></div><div><h2 class="jobSectionHeader"><b><br>
Level/Salary Range:</b></h2><p><br>
$50,000 - $55,000</p><h2 class="jobSectionHeader"><b><br>
Position Type:</b></h2><p><br>
Exempt, Full-time</p></div><div><h2 class="jobSectionHeader"><b><br>
Job Description</b></h2></div><div><div><h1 class="jobSectionHeader"><br>
Workforce Solutions Borderplex is one of 28 public workforce development boards in Texas serving the six-county Borderplex region.</h1><h1 class="jobSectionHeader">
We are a non-profit opportunity incubator, personalizing the career path and connecting the right people to the right positions. With the tools, programs, and services we provide, we know you can do anything you put your heart into. Our organization and its initiatives have been recognized and awarded by the Texas Workforce Commission for our innovative approach to assisting employers and job seekers.</h1><h1 class="jobSectionHeader">
 WSB serves in the spirit of community support. What we do is so important, but we don&rsquo;t do it alone. We serve the regional business community. Our mission is to help them grow stronger so they can create better jobs. We also prepare people to fill those jobs and achieve a sustaining and fulfilling career.</h1><h1 class="jobSectionHeader">
WSB exhibits a growth mindset. We seek individuals who buy into this mission and lead by example by being good stewards of our financial resources, work efficiently to stretch our resources, and support the organization and its community partners so we can collectively elevate the regional economy. Our values include transparency, innovation, accountability, research-driven, impact-driven, integrity, collaboration, and empathy. Join this high-performing team and support a thriving regional economy!</h1><p><br>
<br>
</p><p><b>SUMMARY/OBJECTIVE</b></p><p>
Performs moderately complex investigative, compliance, and technical assistance work related to Child Care Services program integrity and fraud prevention. Work involves conducting investigations, reviewing documentation, interviewing relevant parties, preparing findings and recommendations, and collaborating with internal and external partners to ensure compliance with Texas Workforce Commission requirements and Child Care Development Fund (CCDF) regulations.</p><p><br>
<br>
</p><p><b>ROLE AND RESPONSIBILITIES</b></p><ul><li>
Conduct investigations into allegations of fraud, waste, abuse, and non-compliance involving CCS participants and childcare providers</li><li>
Review eligibility documentation, income verification, employment records, residency documentation, attendance records, and provider billing submissions</li><li>
Conduct interviews with parents, providers, employers, staff, and third-party contacts as necessary</li><li>
Analyze documentation, records, and data to identify inconsistencies, trends, or potential fraudulent activity</li><li>
Prepare detailed investigative reports, summaries of findings, and recommendations for corrective action</li><li>
Support overpayment identification, calculation, and recovery documentation processes</li><li>
Coordinate with CCS eligibility staff, monitoring teams, legal counsel, and Texas Workforce Commission staff</li><li>
Assist with documentation required for appeals, hearings, audits, and compliance reviews</li><li>
Maintain secure and confidential handling of sensitive records and personally identifiable information</li><li>
Identify process gaps, internal control weaknesses, and opportunities for fraud prevention improvements</li><li>
Assist in developing procedures, workflows, and guidance related to fraud investigations and program integrity</li><li>
Conduct field visits and on-site investigations as needed</li><li>
Perform related work as assigned</li></ul><p><b>
EXPERIENCE AND EDUCATION REQUIREMENTS</b></p><p>
Bachelor&rsquo;s degree from an accredited four-year college or university in Criminal Justice, Public Administration, Business, Social Services, Accounting, or a related field is preferred.</p><p>
Minimum 3&ndash;5 years of relevant professional experience in one or more of the following areas:</p><ul><li>
investigations</li><li>
compliance</li><li>
auditing</li><li>
fraud detection</li><li>
public benefits eligibility</li><li>
case management review</li><li>
program monitoring</li></ul><p>
Relevant experience and education may be substituted for one another.</p><p>
Must possess a valid Texas driver&rsquo;s license and meet requirements to be included as an authorized driver on the Workforce Solutions Borderplex commercial insurance policy.</p><p><br>
<br>
</p><p><b>KNOWLEDGE, SKILLS, ABILITIES</b></p><p>
Knowledge of:</p><ul><li>
federal and state Child Care Services regulations</li><li>
Texas Workforce Commission policies and procedures</li><li>
investigative methods and documentation standards</li><li>
public benefits eligibility requirements</li><li>
compliance monitoring and audit principles</li><li>
confidentiality and records management requirements</li></ul><p>
Skill in:</p><ul><li>
analyzing records and identifying discrepancies</li><li>
conducting objective investigations</li><li>
preparing clear and detailed written reports</li><li>
interviewing and fact-finding</li><li>
using Microsoft Office products and case management systems</li><li>
exercising sound judgment and discretion</li></ul><p>
Ability to:</p><ul><li>
gather, assemble, and analyze facts and evidence</li><li>
apply policy and regulations consistently</li><li>
communicate effectively both orally and in writing</li><li>
maintain impartiality and confidentiality</li><li>
work independently and manage multiple investigations simultaneously</li><li>
provide recommendations for corrective action and process improvements</li></ul><p></p><p><b><br>
JOB SPECIFIC COMPETENCIES</b></p><ul><li><i>
Attention to Detail:</i> Ensures information is complete and accurate; follows up with others to ensure that agreements and commitments have been fulfilled.</li><li><i>
Data Gathering &amp; Analysis:</i> Seeks or collects and synthesizes information from a variety of stakeholders and sources in an objective, unbiased manner to reach a conclusion, goal, or judgment, and to enable strategic and leadership decision making.</li><li><i>
Problem Solving:</i> Identifies problems and uses logic, judgment, and data to evaluate alternatives and recommend solutions to achieve the desired organizational goal or outcome.</li><li><i>
Decision Making:</i> Obtains information and identifies key issues and implications to make informed and objective decisions.</li><li><i>
Decision Quality:</i> Makes sound decisions that take into account objectives, risks, implications, and agency and governmental regulations.</li><li><i>
Conflict Resolution:</i> Uses a variety of approaches to manage and resolve concerns, disagreement, and conflict.</li><li><i>
Planning &amp; prioritization:</i> Plans and organizes work activities; manages several tasks at once.</li><li><i>
Adaptability:</i> Adapts quickly to change and easily considers new approaches.</li><li><i>
Results orientation:</i> Focuses on desired results and sets and achieves challenging goals</li><li><i>
External &amp; Organizational Awareness:</i> Identifies and understands how internal and external issues (e.g., economic, political, social trends) impact the work of the organization.</li><li><i>
Risk Analysis:</i> Identifies and manages the risks of failing to detect a misstatement, caused by inadvertent error or fraud that is material to financial statements.</li></ul><p></p><p><b><br>
GENERAL/ORGANIZATIONAL COMPETENCIES</b></p><ul><li><i>
Quality/Compliance:</i> Achieving a standard of excellence with our work processes and outcomes, honoring the organization's policies and all regulatory requirements.</li><li><i>
Customer focus</i>: Striving for high customer satisfaction, going out of our way to be helpful and pleasant, making it as easy as possible on the customer rather than our department or the organization.</li><li><i>
Communication:</i> Balancing listening and talking, speaking, and writing clearly and accurately, influencing others, and keeping others informed.</li><li><i>
Collegiality/Collaboration:</i> Being helpful, respectful, approachable and team oriented, cooperating with others, inside and outside the organization, to accomplish objectives to build and maintain mutually beneficial partnerships, leverage information, and achieve results.</li><li>
Initiative: Taking ownership of our work, doing what is needed without being asked, following through</li><li><i>
Efficiency:</i> Planning, managing time well, being on time, being cost conscious, thinking of better ways to do things.</li><li><i>
Continuous Learning &amp; Self Development:</i> Being receptive to feedback, willing to learn, embracing continuous improvement, proactively investigating new perspectives, approaches, and behaviors.</li><li><i>
Integrity/Transparency:</i> Upholds social, ethical, and organizational norms and values; firmly adheres to codes of conduct and ethical principles; behaves consistently, and is open, honest, and trustworthy; acts without consideration of personal gain.</li></ul><p></p><h1 class="jobSectionHeader"><b><br>
Additional Notes</b></h1><p>
Must possess a valid driver&rsquo;s license and meet requirements to be included as an authorized driver on the Workforce Solutions Borderplex Commercial Package Policy as stipulated by the insurance carrier. Successful clearance of local and/or state background checks.</p><div></div><p><br>
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice based on business needs.</p><p></p><p><b><br>
EEO/ADA</b></p><p>
Workforce Solutions Borderplex provides equal employment opportunities to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by state, federal, or local law. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.</p></div></div></div></div></div></div><br>
<p></p>
Flexible Schedule (with set parameters):<br>
<br>
Select a shift start and end time between 7:00 AM and 6:00 PM.<br>
Monday&ndash;Thursday: Working hours must be between 7 and 10 hours per day.<br>
Friday: Working hours must be 8 hours or less.<br>
A 1‑hour lunch break is required.<br>
Total net work hours must equal 40 hours per week.</div>

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