Fraud Investigator

Job Summary

Performs a variety of tasks related to the verification and investigation of suspected public assistance fraud cases in the Scott Fraud Region (Scott, Carver, and McLeod Counties) as an employee of Scott County Health and Human Services; refers some fraud cases to the Sheriff's Office for investigation and to the County Attorney's Office for possible prosecution. Represents the counties at Disqualification Hearings. Work is performed both in the field and in an office setting.

Job Description

ESSENTIAL DUTIES

• Receives and evaluates referrals of suspected program violations from agency staff, other public agencies, law enforcement units, and the general public. Conducts preliminary investigations including interviewing agency staff and reviewing case files to determine whether further investigation is warranted. 
• Initiates, plans, and conducts all aspects of investigations. Works and coordinates investigations with the State Office of Inspector General (OIG) as determined appropriate.
• Demonstrates knowledge and understanding of human behavior, cultural diversities, and language barriers to ensure equitable service delivery.
• Completes investigative reports and other forms; gets investigative findings back to the workers; maintains documents related to investigations and updates various systems and databases with case outcomes, following all data privacy requirements. Maintains the completed investigation files based on state file retention regulations.
• Prepares and submits hearing requests to the state appeals office for Administrative Disqualification Hearings. Represents and testifies on behalf of each county at these hearings along with other necessary agency staff. May be required to testify in county or district court as requested by the individual counties.
• Obtains and prepares materials and conducts annual training sessions for caseworkers as well as any other training requested by other agency staff on fraud prevention and detection. Assists supervisor with preparation of monthly, quarterly, and annual county and state statistical reports upon which program funding is based.
• Performs agency audits as recommended by management. 
• Works the hours and/or shifts assigned and begins and ends work on time. 
• Performs other related duties as required or assigned.

MINIMUM QUALIFICATIONS

Must have one of the following:
High school diploma or GED and 6 years related experience working with Income Maintenance programs including cash programs, SNAP, Child Care Assistance, and health care
High school diploma or GED plus one year of post-secondary education and 4 years of related experience
Associate's Degree and 2 years of related experience
Bachelor's Degree and 6 months of related experience
Preference given for current experience in one or more of the following: determining program eligibility, investigations, or law enforcement. Strong preference for work experience as a Fraud Investigator. Requires a valid driver's license and a reliable means of transportation for the performance of work responsibilities.

SUPERVISORY CONTROLS

With latitude for independent judgment, the employee works under the general supervision of the Eligibility Supervisor. Work is performed according to established procedures and verbal or written instructions. Work is reviewed by the supervisor for accuracy and adherence to established procedures.

CORE COMPETENCIES AND ABILITIES

• Customer Service - Delivers government services in a respectful, responsive, and solution-oriented manner.
• Communication - Is always clear about what we're doing and why we're doing it.
• Collaboration - Works with partners – communities, schools, faith groups, private business, and non-profit agencies – to see that services are not duplicated but rather are complimentary, aligned, and provided by the partners who can deliver the service most effectively.
• Stewardship - Works proactively to make investments, guided by resident input, which will transform lives, communities, and government.
• Empowerment - Works with individuals and families to affirm strengths, develop skills, restore hope, and promote self-reliance.
• Resiliency - Fosters public preparedness and responds when families and communities face health and safety emergencies.
• Innovation - Takes informed risks to deliver services more effectively and learns from successes and failures.
• Knowledge regarding current federal, state, and local welfare laws as they relate to fraud.
• Knowledge of agency programs, operations, policies, and procedures.
• Knowledge of rules of evidence and correct procedures.
• Knowledge of legal processes for criminal hearings and Administrative Disqualification Hearings.
• Knowledge of investigative interviewing techniques.
• Knowledge of available community resources.
• Ability to interrelate and maintain effective working relationships with the employees, clients, other departments, and the public.
• Ability to make decisions.
• Ability to react quickly in unexpected situations that may occur during investigations.
• Ability to train others.
• Ability to establish and maintain accurate and systematic records.
• Ability to analyze problems on specific fraud cases.
• Ability to prepare reports and accurately and rapidly process detailed information.
• Ability to communicate effectively.
• Ability to speak, present, and interact in public arenas with composure, professionalism, and discretion.
• Ability to use MS Office software for the performance of essential duties.
• Ability to use appropriate discretion in dealing with matters of a confidential nature.

WORK ENVIRONMENT AND PHYSICAL DEMANDS

Typical characteristics of the regular, ongoing work environment of this position requires a significant amount of independent field work. Surveillance and other work related to investigations may be required outside of regular business hours. 

Physical activities include sedentary to light work: Reaching, sitting, standing, walking, pushing, lifting, pulling, fingering, grasping, feeling, stooping, talking, hearing, seeing, and repetitive motions. Lifts and/or navigates up to 35 pounds on a routine basis in handling files and equipment necessary for performing the essential duties of the job.

SELECTION PROCESS

Selection for this position will be based on a minimum qualifications screening and rating of training and experience. Top candidates will be forwarded to hiring manager or supervisor for consideration for interview and/or additional assessments. Final selection will include a background check and approval by the County Board.