Currently, we are looking for one (1) Provider Fraud Analyst (PFA)

Location: Travel to field offices (within 100 miles of any USPS OIG office)

Shift time: Part-time, Monday-Friday, 1,560 hours per calendar year

Dress Code: Business

Security Clearance: Secret/Postal Sensitive

*contingent upon contract award

Position Description:

The PFA will provide investigative support to USPS-OIG Health Care Fraud Provider Investigations.

Duties & Responsibilities

• Evaluate, analyze, and render informed opinions on the delivery of health care treatments and the resulting outcomes.
• Assist in determining issues of liability, medical necessity of a procedure, evaluating the use of ORG (Diagnosis Related Group) and/or CPT (Current Procedural Terminology).
• Handle billing codes.
• Interview witnesses.
• Complete banking analysis.
• Prepare documents that involve the review of medical documents that may be complex and voluminous in nature.
• The PFA would also assist in the proactive development of Health Care Fraud investigations by utilizing agency-specific and other informational databases.

Necessary Knowledge, Skills & Abilities:

• Some knowledge of the laws of evidence, federal investigative policies and procedures, and other internal mechanisms such as automated and manual investigative case management systems.
• Strong analytical skills, including the ability to analyze documents and elicit factual information.
• Good organizational, time management communication, and writing skills.
• Ability to take comprehensive notes and generally detailed, clear, and concise technical or non-technical reports based on the notes taken.
• Strong computer skills.
• Good human relations skills, including the ability to sufficiently communicate orally to express thoughts to a variety of people.
• Ability to travel extensively and for extensive periods as needed.
• A valid driver's license.

Job Type: Part-time

Schedule:

• 4 hour shift
• Monday to Friday

Work setting:

• In-person
• Office

Application Question(s):

• Do you have experience as a Provider Fraud Analyst? If so, explain.

Experience:

• Fraud prevention and detection: 3 years (Required)
• Knowledge of the laws of evidence: 2 years (Required)
• Knowledge of federal investigative policies and procedures: 2 years (Required)
• Knowledge of investigative case management systems: 2 years (Required)

License/Certification:

• Driver's License (Required)

Security clearance:

• Secret (Required)

Work Location: In person