Fraud Investigator II

Virginia Department of Social Services•Stevensburg, VA

4d•$35,138 - $80,000

About The Position

The Fraud Investigator II is the full-performance role responsible for investigating suspected fraud across public assistance programs, determining whether a client acted intentionally, calculating and establishing overpayments, initiating administrative or court action for Intentional Program Violations, and overseeing collections. The role is distinguished from the Fraud Investigator Supervisor, whose primary duties involve supervision and evaluating the work of others. The position receives and tracks allegations, investigates cases, determines whether to pursue an administrative disqualification or refer a case to the Commonwealth’s Attorney’s Office, and works with law enforcement to prepare cases for trial. The investigator may testify in court, train and guide other staff in fraud prevention and detection, prepare reports, review new policies and procedures, maintain the Fraud Free database, and initiate recovery of overpayments. Applicants must hold a valid, unrestricted Virginia driver’s license and meet agency driving and insurability standards. The employee must be willing to serve in a community emergency shelter during a natural disaster or emergency. Employment is contingent on satisfactory background checks and screenings, which may include fingerprinting and criminal history and Central Registry searches.

Requirements

High school diploma supplemented by work experience and/or training involving human services program eligibility or case management work and some legal work, including court involvement, researching criminal citations, investigative techniques, and testimony; or an equivalent combination of training and experience that provides the required knowledge, skills, and abilities.
Working knowledge of investigative techniques, public assistance programs and their policies and regulations, legal proceedings, collection methods, self-defense, applicable laws and procedures including civil and court procedures, basic human behavior, and social problems and resources.
Skill in operating a personal computer and associated office and agency software.
Ability to communicate effectively orally and in writing; perform basic arithmetic; calculate overpayments and track payments; testify in court; train others; establish effective working relationships; work independently; analyze data, identify gaps, and gather information; draw legal and supportable conclusions; prepare reports; use persuasion or influence; document information from interviews, forms, and documents; and organize a work schedule.
Valid Virginia driver’s license without restrictions, with a driving record meeting agency standards by the hire date.
Meet the agency’s required level of insurability.
Willingness to work in the community emergency shelter during a natural disaster or emergency.
Satisfactory completion of required background checks and screenings, which may include fingerprinting, criminal history and Central Registry searches, DMV record checks, employment and education verification, references, credit checks relevant to employment, and a pre-employment drug screen.

Nice To Haves

Bachelor’s degree in human services or a related field.
Experience working as a Fraud Investigator in a Virginia Local Department of Social Services within the last year.
At least two years of working knowledge and experience in one or more of these benefit programs: Temporary Assistance for Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP), Medical Assistance (MA), Energy Assistance (EAP), Child Care (CC), or Percentage of Income Payment Program (PIPP).
Experience using Accurint/LexisNexis, Integrated Revenue Management System (IRMS—State Tax Intercept), Electronic Disqualified Recipient System (eDRS), System Partnering in a Demographic Repository (SPIDeR), Virginia Case Management System (VaCMS), Document Management Imaging System (DMIS), Electronic Benefit System (EBT.EPPIC), or Data Warehouse.

Responsibilities

Receive, evaluate, and track allegations of suspected fraud.
Conduct inquiries and investigations to determine whether clients acted intentionally in all program areas.
Determine whether to pursue an Administrative Disqualification or refer cases to the Commonwealth’s Attorney’s Office.
Calculate overpayments identified through fraud investigations.
Train other staff in fraud prevention and detection and provide guidance as needed.
Work with law enforcement to prepare cases for trial and testify in court as needed.
Prepare reports.
Review new policies and procedures.
Maintain the Fraud Free database tracking system.
Initiate collection actions to recover overpayments.
Serve in the community emergency shelter during a natural disaster or emergency.