Job Description

Fraud Investigator I

Fraud Investigator I represents the entry level and works under close supervision while being trained in investigating fraud for a variety of social services and government assistance programs. Upon recommendation by the supervisor, approval by the director, and successful completion of the training program, the employee shall be redefined to a full-performance Fraud Investigator II becomes eligible for a pay increase as defined by the local agency compensation plan.

The Fraud Investigator I is distinguished from the Fraud Investigator II by the latter's performing all the assigned fraud investigation duties independently and making judgments following agency practices and procedures and mandated Federal, State, or local laws and policies.

General Work Tasks (Illustrative Only) –

• Receives, evaluates and tracks allegations of suspected fraud;
• Conducts an inquiry and investigation into the allegation in an effort to determine intent or no intent on the part of the client in all program areas;
• Determines an Administrative Disqualification or refers to the Commonwealth's Attorney Office;
• Calculates overpayments when the overpayment is discovered through a fraud investigation;
• Prepares reports;
• Reviews all new policy and procedures; and
• Maintains Fraud Free database tracking system.

Knowledge, Skills, and Abilities: Knowledge-

Some knowledge of: investigative techniques; public assistance programs; legal proceedings; collection methods; self-defense; public assistance program policies and regulations; applicable laws, codes, policies and procedures, including civil and court procedures; basic human behavior; and social problems and resources.

Skills-

Skill in operating a personal computer and the associated office and agency software.

Abilities-

Demonstrated ability to: communicate effectively both orally and in writing; perform addition, subtraction, multiplication, and division; calculate overpayments and track payments; testify in court proceedings; establish and maintain effective working relationships with clients, associates, law enforcement, other agencies and others; work independently; analyze data, recognize gaps and collect information; draw legal and supportable conclusions; prepare reports; apply principles of persuasion and/or influence; document data from interviews, forms, and documents; and organize own work schedule.

Education and Experience-

High school diploma supplemented by work experience and/or training involving human services program eligibility, case management work, or some legal work OR any equivalent combination of training and experience which provides the required knowledge, skills and abilities.

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