Benefit Programs Specialist II - Fraud

Virginia Department of Social ServicesChesapeake, VA

About The Position

This job announcement is a courtesy job post for the Chesapeake County local Social Services agency. It is not a position of the Virginia Department of Social Services or any other Commonwealth of Virginia agency. Local employment opportunities may also be available through the local agency’s city or county website/job board(s). https://jobs.cityofchesapeake.net/postings/17631

Requirements

  • Requires any combination of education and experience equivalent to a bachelor’s degree in accounting, sociology, or a closely related field
  • Requires a minimum of one year of related, full-time equivalent experience
  • Communicate effectively both orally and in writing
  • Perform addition, subtraction, multiplication, and division
  • Calculate overpayments and track payments

Nice To Haves

  • Three or more years of experience working directly with Virginia Division of Social Services Benefit Programs and/or Child Care Programs
  • Knowledge of investigative techniques
  • Knowledge of public assistance programs, legal proceedings, collection methods
  • Knowledge of applicable laws, codes
  • Knowledge of Virginia Division of Social Services Benefit Program Fraud policies and procedures including civil and court procedures
  • One year of SPIDeR, VaCMS, DMIS, and MMIS experience in determining Eligibility in the In-take/On-Going unit

Responsibilities

  • 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
  • Calculates overpayments when the overpayment is discovered through a fraud investigation
  • Prepares reports
  • Applies principles of persuasion and/or influence
  • Documents data from interviews, forms, and documents
  • Organizes own work schedule
  • Reviews all new policy and procedures
  • Stays abreast of federal, state, and local guidelines and regulations for area of responsibility
  • Maintains Fraud Free database tracking system
  • Interviews customer and conducts assessment of eligibility for services
  • Explains available programs and services
  • Assists with completion of application process
  • Dictates narrative of case
  • Completes computer forms to establish case on various computer systems
  • Analyzes available information and determines and recommends client eligibility
  • Examines public assistance records/cases for completeness and accuracy
  • Reviews accounts payable to ensure accuracy and timeliness of assistance payments
  • Performs routine office tasks such as typing correspondence, data entry, filing, telephoning, faxing, and photocopying
  • Maintains record system for area of responsibility
  • Attends staff, team, committee, and other professional meetings to exchange information
  • Meets with general public and community organizations to discuss programs for area of responsibility
  • Receives referrals of suspected fraud form program workers and other sources including community complaints (anonymous or not) and computer matches
  • Analyzes allegations and identifies the program regulations which have been violated
  • Gathers and analyzes evidence to substantiate that fraud has or has not occurred
  • Testifies in court proceedings
  • Establishes and maintains effective working relationships with clients, associates, law enforcement, other agencies and others
  • Conducts witness and suspect interviews and takes statements as appropriate
  • Works independently
  • Analyzes data, recognizes gaps and collects information
  • Draws legal and supportable conclusions
  • Establishes intent, if it exists
  • Determines suitability of cases for the Administrative Disqualification Hearing (ADH) processor for prosecution based on guidelines provided by the local Commonwealth’s Attorney
  • Prepares comprehensive investigative reports
  • Testifies in court or presents evidence at ADH’s
  • Maintains appropriate record and files
  • Compiles statistical information and creates reports as required
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