Senior Benefits Program Specialist (Fraud Investigator)
James City County Social Services Department seeks an individual to perform advanced work investigating allegations of possible fraud by gathering and evaluating evidence and information, writing reports, presenting evidence in appeals hearings or in court and determining overpayments.
• Researches and investigates assigned suspected fraud cases; interviews clients and employees to gather case information; determines overpayments and whether intent to defraud exists; obtains assistance from law enforcement officials to interview and obtain oral or written statements from customer and family members suspected of fraud.
• Prepares summaries of facts for fraud and overpayment; contacts employers, creditors, landlords, police department representatives and others to gather information in support of the suspected fraud case.
• Represents the agency in hearings and court appeals and takes appropriate action as required; responds to state, federal and internal case review inquires; prepares summaries for the Commonwealth Attorney’s decision to prosecute or seek resolution; presents evidence to the grand jury for the purpose of obtaining indictments; prepares witnesses for court appearances; represents the agency as expert witness for the prosecution; and, testifies in court.
• Initiates voluntary or mandatory collection activities to recover funds from overpayment; pursues voluntary repayment of overpayments when fraud prosecution is not indicated. Performs extensive calculations for the amount of overpayment by program category; enters data into state and local computer system and performs necessary inquires, system searches and updates to coordinate related information. Prepares reports on fraud and non-fraud activities.