Review data from vendors who provide health care services paid by the federal government to identify anomalies that might be indicative of improper billing or other types of fraud.
Formulate data runs or inquiries from large Medicare and Medicaid databases to elicit particular billing patterns to analyze and research.
Analyze data and draft written conclusions and recommendations regarding possible fraudulent billing patterns to be further investigated.
Prepare interim and final reports on progress of findings for use by AUSAs and supervisory attorneys. Reports shall include significant findings, conclusions, and recommendations for additional investigative actions, and candid assessments of strengths and weaknesses of witnesses, documentary evidence, and other aspects of the case.
Work with the assigned AUSAs, supervisory AUSAs and/or and investigators to determine applicable administrative statutory and regulatory law and identify possible violations or causes of action.
Develop an understanding of all applicable federal, state, or local laws to the extent necessary to make sound decisions on direction and scope of investigation. Determine proof required to assist in affixing legal responsibility for litigation, and devise methods for obtaining, preserving, and presenting evidence to greatest effect.
Initiate contacts with federal, state, and local officials, and other organizations, including Medicare and Medicaid contractors, related to the subject of the investigation for the purpose of gathering facts, obtaining records, learning sequences of events, obtaining explanations, and otherwise advancing investigative objectives. Examine records, correspondence, audits, or reviews pertaining to the transactions, events, or allegations under investigation. Establish and verify relationships among all facts and evidence obtained and presented to confirm authenticity of documents, corroborate witness statements, and otherwise build proof necessary to successful case resolution.
Assist in the compilation and analysis of documents and physical evidence, and creation of charts and graphs for use in hearings, presentations, or trial.
Review defense presentations, expert reports, and arguments.
Create financial damage models for use in litigation.
Participate in negotiations as requested.
Travel with USAO MD personnel to conduct interviews.
Work with independent experts/consultants.
Required Qualifications:
Experience in document analysis, particularly in relation to fraud cases.
Two years’ experience in performing on-line database research and telephone research.
Working knowledge of various public repositories of information. Familiarity with specific subject matter helpful - Medicare and Medicaid claims, student loan programs, DoD contracting, etc.
Excellent oral and written communication skills.
Undergraduate degree preferred; familiarity with automated litigation support helpful.
Must be able to obtain and maintain MRPT facility credentials/authorization. Note: US Citizenship is required for MRPT facility credentials/authorization at this work location.
Location: Baltimore, MD or Greenbelt, MD
Amentum is proud to be an Equal Opportunity Employer. Our hiring practices provide equal opportunity for employment without regard to race, religion, color, sex, gender, national origin, age, United States military veteran’s status, ancestry, sexual orientation, gender identity, marital status, family structure, medical condition including genetic characteristics or information, veteran status, or mental or physical disability so long as the essential functions of the job can be performed with or without reasonable accommodation, or any other protected category under federal, state, or local law. Learn more about your rights under Federal EEO laws and supplemental language at EEO including Disability/Protected Veterans ( and Labor Laws Posters ( .
...40 years of experience and dedication to enhancing the quality of life. Arcadia has immediate need for Certified Nursing Assistants (CNA) throughout Michigan! We are offering virtual job interviews as a safety measure against COVID-19. We are urgently hiring CNAs in these...
...The Challenge: We are seeking an experienced and safety-focused Heavy Haul Driver to transport oversized and overweight loads up to 70... ...knowledge of DOT regulations, and the ability to operate heavy-haul trucks with various trailer configurations, including multi-axle, step...
...Job Description Job Description RoseHarbor Publishing is looking to secure a talented Series Editor for multiple series of novel-length books (80,000-90,000 words) within the mafia romance genre. We are seeking a dependable editor to work with long-term in a team...
...run extremely fast with very little paperwork and a solid inside sales support staff? Were you kicked out of the family games over... ...company where you can shape the trajectory of a division Flooring experience is not required. Influence and relationships are more...
Summary Childrens Hospital of The Kings Daughters, the regions most trusted name in pediatric care, is much more than a hospital. We offer all the healthcare services children need, including primary care pediatricians! With CHKD Medical Group (CMG), youll join more...