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

Atlanta, GA 30303

TELEWORK

CLEARANCE

U.S. citizenship required since this role supports the U.S. federal government

CLIENT

Department of Justice (DOJ)

TRAVEL

Travel may be required

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.

KMRG, LLC jobs

Data Analyst — Healthcare Fraud