Healthcare Fraud Investigator

Cameo Consulting Group•Nashville, TN

7d•Onsite

About The Position

Cameo Consulting Group, LLC is seeking an experienced Healthcare Fraud Investigator to provide investigative support for civil healthcare fraud prosecutions on behalf of the U.S. Department of Justice. The investigator will work closely with Assistant U.S. Attorneys (AUSAs) to review, analyze, and develop healthcare fraud cases in compliance with federal Medicare and Medicaid regulations.

Requirements

Bachelor’s degree or higher in Criminal Justice, Finance, Project Management, or a related field.
Minimum of 3 years of professional experience in healthcare fraud investigation, healthcare compliance, or a related investigative field.
Experience with federal healthcare programs (Medicare/Medicaid) strongly preferred.
Proficiency in Microsoft Excel and data analysis tools required.
Strong analytical, research, and report-writing skills.
Ability to interpret complex legal and regulatory documents.
Excellent communication and collaboration skills.
High ethical standards and ability to handle confidential information.
Ability to work independently and under the direction of AUSAs.
Must be able to obtain and maintain required DOJ security clearance
Must complete DOJ ethics training and Cybersecurity Awareness Training (CSAT) upon hire.
Must adhere to all DOJ security, confidentiality, and conduct standards.

Nice To Haves

Experience with federal healthcare programs (Medicare/Medicaid) strongly preferred.

Responsibilities

Review, sort, and analyze complex data using Microsoft Excel and other software tools.
Examine financial records, legal documents, and regulatory filings to identify evidence of fraud, waste, and abuse.
Prepare detailed spreadsheets of financial transactions (e.g., check spreads).
Develop healthcare fraud case referrals that meet USAO litigation standards.
Evaluate referrals to determine need for additional evidence and plan investigative approaches.
Advise attorneys on case merits, liability, damages, and potential defenses.
Assist in witness interviews and prepare written summaries.
Support development of new referrals through collaboration with federal, state, and local agencies.
Assist in training and preparation of informational materials related to healthcare fraud.
Perform other related duties as assigned within scope.

Benefits

Medical Insurance: Premium options with cost-sharing between the company and employee.
100% Employer-Paid Insurance: Cameo fully covers premiums for Dental, Vision, Basic Life, and Accidental Death & Dismemberment (AD&D) insurance.
Disability Insurance: Options for both short-term and long-term disability coverage.
401(k) Retirement Plan: A plan to help employees save for the future.
Flexible Spending Accounts (FSA): Pre-tax accounts for eligible healthcare and dependent care expenses.
Federal Holidays: Paid time off for 11 federal holidays per year.
Paid Time Off (PTO) / Sick Leave: A combined bank of paid leave for vacation, personal time, and illness.
Other Leave: Paid time off for bereavement and jury duty.
Employee Assistance Program (EAP): Confidential counseling and support services for personal or work-related challenges.
Where We Work Program: A flexible work policy that may include a mix of hub office work, work-from-home, and fully remote roles, depending on the position.
Tuition Reimbursement: Financial support for continued education and degree programs.
Continuous Training: Access to training programs for professional development.
Employee Referral Bonus: A cash bonus for referring successful candidates.
Shopping Discounts: Access to an employee discount program for various retailers and services.