Peraton Corporation Fraud Investigator - Medicare in Pierre, South Dakota
Peraton drives missions of consequence spanning the globe and extending to the farthest reaches of the galaxy. As the world’s leading mission capability integrator and transformative enterprise IT provider, we deliver trusted and highly differentiated national security solutions and technologies that keep people safe and secure. Peraton serves as a valued partner to essential government agencies across the intelligence, space, cyber, defense, civilian, health, and state and local markets. Every day, our 22,000 employees do the can’t be done, solving the most daunting challenges facing our customers.
We are an Equal Opportunity/Affirmative Action Employer. We consider applicants without regard to race, color, religion, age, national origin, ancestry, ethnicity, gender, gender identity, gender expression, sexual orientation, marital status, veteran status, disability, genetic information, citizenship status, or membership in any other group protected by federal, state, or local law.
As a government contractor, Peraton abides by the following provision
Pay Transparency Nondiscrimination Provision
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of the other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c).
BS 5-7 Years, MS 3-5, PhD 0-2
Three to five years investigative experience preferred
Strong investigative skills
Strong communication and organization skills
Experience in reviewing claims for technical requirements, performing medical review, and/or developing fraud cases
Strong PC knowledge and skills
Ability to communicate effectively, internally and externally
Ability to perform research and draw conclusions
Ability to present issues of concern, citing regulatory violations, alleging schemes or scams to defraud the Government
Ability to interpret laws and regulations
Ability to organize a case file, accurately and thoroughly document all steps taken
Ability to compose correspondence, reports and referral summary letters
Ability to educate providers, provider associations, law enforcement, other contractors and beneficiary advocacy groups on program safeguard matters
Ability to handle confidential material.
Ability to report work activity on a timely basis.
Ability to work independently and as a member of a team to deliver high quality work
Ability to attend meetings, training, and conferences, overnight travel may be required
This position may require the incumbent to appear in court to testify about work findings.
SafeGuard Services (SGS), a subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse.
Since 1999, SGS has prevented more than $9.65 billion in inappropriate payments, consisting of nearly $5.98 billion in proactively Prevented Dollars and more than $3.69 billion in Recovered Dollars. Our experience with fraud and abuse analytics has resulted in the referral of thousands of cases to law enforcement and resulted in successful criminal and civil prosecution and civil monetary penalties.
The position requires the individual to use a variety of tools to initiate investigations, identify subjects and develop cases for future action, including referral to law enforcement, education, over payment recovery and other administrative actions. Will work with internal resources and external agencies to develop cases and corrective actions as well as respond to requests for data and support.
For Colorado Residents
Colorado Salary Minimum: $51,251.20
Colorado Salary Maximum:$109,574.40
The estimate displayed represents the typical salary range for this position, and is just one component of Perspecta's total compensation package for employees. Other rewards may include annual bonuses, short- and long-term incentives, and program-specific awards. In addition, Perspecta provides a variety of benefits to employees.
Job Locations US
Requisition Post Information* : Posted Date 1 month ago (5/13/2021 9:59 AM)
Requisition ID 2021-105318
Position Category Investigation
Clearance No Clearance Required
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