ROLE
We are looking for an experienced Data Analyst for Healthcare Fraud to support the U.S. Attorney’s Office, Northern District of Georgia (USAO NDGA). Your scope of work includes providing expert claims data statistical and financial analysis, designing fraud detection techniques, conducting financial examinations, and gathering evidence through interviews.
This is a full-time opportunity in which we’ll provide competitive pay, comprehensive benefits, and job stability and security.
Apply today!
RESPONSIBILITIES
I. Data Analysis:
- Analyze databases from Medicaid, Medicare (i.e., Part A, Part B, and Part D), and other federal agencies
- Organize, analyze, and present data using common software programs (e.g., Case Map7, I-Pro7, and STARs)
- Create and evaluate statistically valid random samples (SVRS)
- Create, analyze, and defend statistically valid random samples from data pools
- Perform quantitative, qualitative, and statistical analysis on relevant data and facts to support investigations
- Develop data techniques to demonstrate and prove fraud in healthcare fraud cases
- Support Civil Division investigations and litigation using data analysis
II. Fraud Detection:
- Design data techniques for fraud detection
- Develop data techniques to demonstrate and prove fraud in healthcare fraud cases
III. Financial Analysis:
- Analyze a large variety of accounting systems and financial records
- Examine financial books, records, electronic data, and activities
- Obtain detailed financial information from other sources
- Reconstruct partial/inadequate records using automated systems and database applications
- Prepare audit reports by analyzing claims data, financial records, and/or tax records
- Create detailed charts and schedules
IV. Electronic Data Management:
- Use electronic resources for data management and presentation in investigations and litigation
- Collect, organize, and quality check large and complex electronically stored information (ESI)
- Upload ESI to document management and review platforms (e.g., Relativity, Everlaw, Eclipse)
- Review, manipulate, and tag or index ESI productions
- Pull, compile, and prepare documents from review platforms
V. Communication & Legal Support:
- Communicate complex claims data and financial information
- Help prepare legal documents for investigation, witness interviews, hearings, or trials
- Discuss cases with Assistant U.S. Attorneys (AUSA) and recommend further courses of action
- Present oral briefings and testimony
- Prepare written material that will be used as evidence in court proceedings
- Testify in court if necessary
- Gather evidence from interviews and relevant stakeholders
KNOWLEDGE & SKILLS
- Knowledge of legal and law enforcement terms and procedures
- Knowledge of legal research using tools (e.g., Lexis/Nexis and/or Westlaw)
- Knowledge of medical terminology, procedures codes, and reimbursement procedures
- Knowledge of statistical theory and analysis
- Knowledge of current research and investigative techniques
- Knowledge of financial accounting records and ability to analyze financial records
- Knowledge of the theory, concepts and practices of accounting and auditing
- Skilled in using word processing software, spreadsheet software, and Microsoft Office (e.g., Excel, Word, Access, etc.)
- Knowledge of Adobe Acrobat and Word Perfect
BACKGROUND
- Experience working in forensic accounting, health care fraud, nursing, legal, and/or law enforcement
- Experience interviewing potential witnesses preferred
- Excellent written and oral communication skills
- Strong organizational skills
- Independent & Problem Solver
- Valid driver’s license required
EDUCATION
- Undergraduate degree preferred
LOCATION
TELEWORK
CLEARANCE
- U.S. citizenship required since this role supports the U.S. federal government
CLIENT
- Department of Justice (DOJ)
TRAVEL
WORK HOURS
- 40 hours per week
- 8 hours per day
EMPLOYMENT CLASSIFICATION
- Employment Classification Eligibility — Nonexempt
RELOCATION
- Not eligible for relocation benefits
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KMRG, LLC is an Equal Opportunity/Affirmative Action (EEO/AA) employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex, gender identity, sexual orientation, ancestry, national origin, age, marital or civil partnership status, mental disability, physical disability, medical condition, pregnancy, maternity status, political affiliation, military or veteran status, genetic information, traits historically associated with race, or any other basis prohibited by federal, state, and/or local law.
Other Considerations. Applicants will be subject to a background investigation. Individual’s primary workstation is located in an office area. The noise level in this environment is low to moderate. Regularly required to sit for extended periods up to 100% of the time; frequently required to move about to access file cabinets and use office equipment such as PC, copier, fax, telephone, cell phone, etc. Occasionally required to reach overhead, bend, and lift objects of up to 10 lbs. Specific vision abilities required by this job include the use of computer monitor screens up to 100% of the time.