Income Maintenance Fraud Investigator II

Bladen County•Elizabethtown, NC

About The Position

To perform special investigative work in the area of fraud as related to the determination and re-determination of applicants' eligibility for public, medical, or food and nutrition assistance. Performs specialized clerical work in support of Department of Social Services operations. Receives information regarding and/or audits department case files to identify suspected cases of fraud. Reconstructs case files; analyzes files according to current rules, regulations and procedures, as well as those that were in place at the time of the alleged error or fraud. Investigates cases, gathering evidence from various groups and individuals, including department staff, clients’ employers, family members, insurance companies, financial institutions, government agencies, etc. Contacts clients with regard to established claim; sets administrative disqualification hearings (ADH) for fraud cases, and sets up collection plans for non-fraud cases. Prepares fraud cases for presentation in ADH or for court; testifies in court as necessary. Assists local, state and federal law enforcement agencies with the prosecution of fraud cases. Enters and maintains information into EPICS database. Prepares and mails collection letters to delinquent clients; posts funds received into the database. Reconciles daily, bi-weekly, monthly and quarterly reports. Assists case workers in detecting errors in their caseloads. Receives and responds to inquiries, requests for assistance and complaints regarding areas of responsibility. Performs a variety of other clerical duties in support of department activities, which preparing various reports and records, compiling information and data, copying and filing documents, sending and receiving faxes, entering and retrieving computer data, answering the telephone, etc. Operates a variety of equipment, which includes a computer, printer, typewriter, fax machine, copier, telephone, calculator, postage machine, paper shredder, etc.; uses clerical and computer supplies. Interacts and communicates with various groups and individuals such as the immediate supervisor, co-workers, other County personnel, other government agencies, clients and family members, and the general public. Attends meetings, training, workshops, etc., as required to enhance job knowledge and skills. Serves as hearing officer for local appeal hearings. May assist with special projects or programs as assigned, which may include but is not limited to securing food resources for families in need, delivering commodities to various County sites, staffing emergency shelters, etc. Performs related duties as required.

Requirements

Thorough knowledge of the methods, policies and procedures of the Department and County pertaining to specific duties of the IM Fraud Investigator II.
Knowledge of the processes involved in determining fraudulent or criminal activity associated with the receipt of department services.
Knowledge and use of good organizational, interpersonal and clerical skills.
Knowledge of modern office practices and equipment.
Knowledge of proper English usage, vocabulary, punctuation and spelling.
Knowledge of basic mathematics.
Skilled in applying responsible attention to detail as necessary in preparing records and reports.
Ability to comprehend, interpret and apply regulations, procedures and related information.
Ability to conduct thorough investigations of suspected fraud, compile and analyze findings, and determine case resolution.
Ability to prepare cases for prosecution in court as necessary, and to provide court testimony.
Ability to maintain accurate, up-to-date and confidential records.
Ability to read and interpret various materials pertaining to the responsibilities of the job.
Ability to use computers for data and word and data processing and records management.
Ability to type accurately at a rate sufficient for the successful performance of assigned duties.
Ability to operate and maintain a variety of office equipment as necessary in the performance of daily activities.
Ability to read, and verify for accuracy and completeness, financial / insurance records and various other documents pertaining to the responsibilities of the job.
Ability to use independent judgment in performing routine tasks.
Ability to plan, organize and prioritize daily assignments and work activities.
Ability to offer assistance to fellow employees as necessary.
Ability to learn and utilize new skills and information to improve job performance and efficiency.
Ability to perform duties in a courteous manner and with the utmost integrity in the best interest of the public.
Ability to work under stressful conditions as required.
Ability to react calmly and quickly in emergency situations.
Valid North Carolina Driver’s License

Responsibilities

Audits department case files to identify suspected cases of fraud.
Investigates cases, gathering evidence from various groups and individuals.
Contacts clients with regard to established claim.
Sets administrative disqualification hearings (ADH) for fraud cases.
Sets up collection plans for non-fraud cases.
Prepares fraud cases for presentation in ADH or for court.
Testifies in court as necessary.
Assists local, state and federal law enforcement agencies with the prosecution of fraud cases.
Enters and maintains information into EPICS database.
Prepares and mails collection letters to delinquent clients.
Posts funds received into the database.
Reconciles daily, bi-weekly, monthly and quarterly reports.
Assists case workers in detecting errors in their caseloads.
Receives and responds to inquiries, requests for assistance and complaints regarding areas of responsibility.
Performs a variety of other clerical duties in support of department activities.
Operates a variety of equipment, which includes a computer, printer, typewriter, fax machine, copier, telephone, calculator, postage machine, paper shredder, etc.
Attends meetings, training, workshops, etc., as required to enhance job knowledge and skills.
Serves as hearing officer for local appeal hearings.
May assist with special projects or programs as assigned.