Benefit Programs Specialist II - Fraud

Virginia Department of Social Services•Chesapeake, 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).

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
Depending on departmental operational requirements, may require valid driver’s license and driving record in compliance with City Driving Standards
Employees may be expected to work hours in excess of their normally scheduled hours in response to short-terms department needs and/or City-wide emergencies
Emergency operations support work and work locations may be outside of normal job duties
Demonstrated ability to: 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; public assistance programs, legal proceedings, collection methods; 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
prepare reports; apply principles of persuasion and/or influence; document data from interviews, forms, and documents; and organize own work schedule
Reviews all new policy and procedures; and stays a breast 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(s) and identifies the program regulations(s) which has been violated
Gathers and analyzes evidence to substantiate that fraud has or has not occurred
Testify in court proceedings; establish and maintain effective working relationships with clients, associates, law enforcement, other agencies and others
Conducts witness and suspect interviews and takes statements as appropriate
Work independently; analyze data, recognize gaps and collect information; draw 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