Program Worker II - Fraud

Please see Special Instructions for more details.

• Fraud investigations require gathering objective evidence before making any determination. Describe the investigative methods you would use to collect, verify, and document evidence while ensuring your findings are fair, impartial, and supported by policy.
• Describe the investigative methods you would use when reviewing a potential fraud referral. How would you gather and evaluate evidence to determine whether additional investigation is warranted?

Working Title of Vacant Position

Full Time

Public

1

HUMAN SVCS

HS-SOCIAL SERVICES ADMIN

2026324

40

Monday
- Friday 8 am - 5 pm
.

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.

Chesapeake, Va. (100 Outlaw Street)

O
- Occasional

GE09

Semi-Monthly

$50,607/ annually

Starting salary based on qualifications and experience

Benefits Program Worker II – Fraud Investigator

The purpose of the position is to assist and support Chesapeake citizens in obtaining services provided by public and private agencies, and/or perform quality control for area of responsibility. The position is responsible for quality control and/or client assessment, investigating fraud, calculating over payments, initiating Administrative or Court Action on all Intentional Program Violations, establishing over payment and overseeing collections referrals, eligibility determination for financial and medical assistance, service delivery, and reporting.

The position works within a general outline of work to be performed; develops work methods and sequences under general supervision.

The tasks listed below are those that represent the majority of the time spent working in this position. Management may assign additional tasks related to the type of work of the position as necessary.

• 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 over payments when the over payment 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.
• 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.
• Demonstrated ability to: communicate effectively both orally and in writing; perform addition, subtraction, multiplication, and division; calculate over payments and track payments;
• 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…