[Hiring] Fraud Referral Specialist @Peraton

Role Description

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. We are looking to add a Fraud Referral Specialist to our SGS team of talented professionals.

What you'll do:

• Use a variety of tools to assist in the evaluation of referrals and complaints.
• Develop investigations to identify potential fraud, including:
  • Responding to referrals from other entities.
  • Fielding requests for data and support.
  • Analyzing and interpreting claims data for aberrancies.
  • Conducting interviews.
  • Reporting findings with a focus on taking quick and appropriate follow-up actions.
• Perform research and draw conclusions.
• Present issues of concern, citing regulatory violations, alleging schemes or scams to defraud the Government.
• Organize a case file, accurately and thoroughly document all steps taken.
• Conduct background investigations on providers within the Medicare program.
• Compose correspondence, reports, and referral summary letters.
• Educate providers, provider associations, law enforcement, other contractors, and beneficiary advocacy groups on program safeguard matters.

Telework available from AL, GA, FL, NC, SC, TN, VA, WV.

Qualifications

• 0 years with BS/BA; 4 years with a HS Diploma/equivalent.
• Strong interpersonal, analytical, research, and organizational skills.
• Excellent verbal and written communications.
• Strong PC knowledge and skills.
• Strong use of Excel and ability to sort and filter data.
• Strong time management and organizational skills.
• Self-driven and motivated.
• U.S. citizenship required.

Requirements

• 1 or 2 years of investigative or analytical experience preferred.
• This position may require the incumbent to appear in court to testify about work findings.
• Ability to communicate effectively, internally, and externally.
• Ability to interpret laws and regulations.
• 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; some overnight travel required.

Benefits

• Medical, dental, and vision insurance.
• Life insurance.
• Health savings account.
• Short/long term disability.
• Employee Assistance Program (EAP).
• Parental leave.
• 401(k) plan.
• Paid time off (PTO) for vacation.
• Company paid holidays.

Company Description

Peraton is a next-generation national security company that 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, highly differentiated solutions and technologies to protect our nation and allies. Peraton operates at the critical nexus between traditional and nontraditional threats across all domains: land, sea, space, air, and cyberspace. The company serves as a valued partner to essential government agencies and supports every branch of the U.S. armed forces. Each day, our employees do the can’t be done by solving the most daunting challenges facing our customers.