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 ( .
...An esteemed law firm is seeking two Environmental & Land Use Associates to join its Los Angeles office. This role is ideal for candidates with 25 years of experience who are adept at drafting briefs and motions. Judicial clerkship experience is a plus. Qualifications...
...Job Overview: Supply JCMC with both sterile and non-sterile products. Qualifications: Required: A High School diploma... ...Must have minimum 6 months of hospital Sterile Processing experience Must have their 400 hours completed Must be able to lift...
Director, Social Media & Influencer Marketing Strategy, Boston, MA Country: United States of America Position Overview The Director... ...shaping the banks online presence, customer engagement, and brand narrative. Reporting to the SVP, Head of Brand and...
...Carrollton areas. ~ Must be available for a minimum of 3 of 5 weekdays ~ Must be at least 18 years of age. ~ Must have a valid driver's license and your own reliable transportation to get to and from class locations. Classes are held at different child care centers...
...Oregon Health Authority Salary Range: $6,123 - $9,409 Position Type: Employee Position Title: Coverage Analytics Policy Analyst (OPA 3) Job Description: Attention current State of Oregon employees: To apply for posted positions, please close this window...