Healthcare Fraud Investigator

SGI Global•Oxford, MS

2d•Onsite

About The Position

SGI is seeking a Healthcare Fraud Investigator to provide investigative support services at the United States Attorney's Office (USAO), Northern District of Mississippi, in Oxford, Mississippi. The Healthcare Fraud Investigator will support Assistant United States Attorneys (AUSAs) by conducting complex civil and administrative investigations involving healthcare fraud matters. Responsibilities include analyzing financial and medical records, conducting witness interviews, coordinating with federal and state agencies, and preparing detailed investigative reports. The position supports litigation activities and ensures the development of evidence necessary for successful case resolution. Position is contingent upon award.

Requirements

Bachelor's Degree required
At least five (5) years of demonstrated experience conducting investigations related to healthcare fraud or similar matters
Experience analyzing complex financial and medical records
Ability to work independently and as part of a legal team in high-profile or sensitive investigations
Strong written and verbal communication skills, including report writing and courtroom testimony
Proficiency with investigative and legal research tools (e.g., LexisNexis, Westlaw, or similar systems)
Strong organizational and analytical skills
U.S. Citizenship required
Ability to obtain and maintain a high-risk background investigation (BI clearance)

Responsibilities

Conduct thorough and systematic investigations into healthcare fraud and related civil or administrative violations
Work closely with AUSAs to plan investigative strategies, determine applicable laws, and identify potential violations
Analyze financial records, billing data, medical documentation, and other evidence to identify fraudulent activity
Initiate and maintain contact with federal, state, and local agencies, as well as witnesses and relevant parties
Conduct in-person and telephonic interviews to gather facts, obtain statements, and verify information
Develop and implement investigative plans, including identifying resources and methods for evidence collection
Coordinate with law enforcement agencies regarding subpoenas, warrants, and surveillance activities as needed
Utilize forensic and analytical tools to examine evidence, including electronic data and financial records
Organize, preserve, and manage documentary and physical evidence for litigation purposes
Prepare interim and final investigative reports summarizing findings, conclusions, and recommendations
Assist AUSAs in trial preparation, including compiling exhibits and developing charts, graphs, and other materials
Provide input on witness selection and ensure witness availability for hearings and trial proceedings
Testify in court regarding investigative findings, as required
Coordinate with stakeholders including courts, law enforcement agencies, and regulatory bodies
Perform other duties as assigned in support of litigation activities