Fraud Investigator

Position closes: 2/28/2025

Hiring pay range: $25.08 - $30.72

Full pay range: $25.08 - $36.36

Supervision

Non-supervisory position.

General Purpose Of Job

Conduct investigations to prevent and detect fraud in Economic Security programs. Investigates alleged fraud program violations and submits cases to law enforcement authorities for criminal and civil action. Presents the testimony of the fraud investigation in court.

Essential Job Functions

(These duties are illustrative of typical essential responsibilities of the job, and may vary according to assignment)

Fraud Investigation

• Reviews fraud referrals. Researches the Colorado Department of Human Services and Health Care Policy and Financing regulations to determine if an investigation is necessary.
• Conducts investigations, complying with applicable regulations and statutes.
• Gathers necessary data and documentation regarding allegations of program fraud.
• Works EBT fraud workbook.
• Determines if provider or recipient received overpayment because of agency error, client error, intentional violation, or criminal fraud.
• Prepares written report of findings, evidence, testimony, and documentation for submission to Law Enforcement and/or District Attorney’s Office for filing of criminal action, intentional program violation hearing, determination of client error, or to close the investigation as unfounded or insufficient evidence.
• Meets with legal staff in pretrial and trial conferences to assist in the preparation and presentation of criminal prosecution; presents testimony on results of investigation.
• Initiates disqualification for a provider or recipient found fraudulent through court order or intentional program violation. Notifies recipient describing length of the disqualification, regulations that apply to the action, and the date that the action will take place.
• Gathers, organizes, and secures all evidence in criminal or civil cases.
• Maintains fraud investigation database.
• Maintains accurate accounting records regarding program integrity functions, the number of cases referred for action, the number of recoveries established, including type, amounts of overpayments recovered and amount of savings.
• Verifies and authenticates documents discovered during an investigation.
• Maintains up to date knowledge of State rules, regulations, and program area eligibility requirements.
  
  

Other duties as assigned.

Core Competencies

(Representative of the knowledge, skills, and abilities expected of the position)

• Public Service: A commitment to the mission of providing exceptional services to the citizens of Garfield County. It is who we are, and what we do.
• Customer Service: A commitment to providing exceptional service to all customers (internal & external), which includes being helpful, professional, courteous, and taking the time to understand customer’s needs.
• Stewardship & Innovation: Is a good steward of public resources and looks for ways to be innovative and improve efficiencies.
• Teamwork: Able to work together with a diverse group of people towards a shared goal, while considering the needs of others.
• Business Technology: Ability to utilize the technology required of the position and demonstrates a willingness to learn new technologies as required to assist the County in providing exceptional services, innovation, and work efficiencies.
• Communication: Proficient in communication, and able to communicate using the English language, including written, verbal, or other communication channels as required by the position.
• Integrity: Maintain a high level of confidentiality and professionalism while performing essential job functions.
  
  

Benefits

• Medical, Vision, Dental
• Disability & Life Insurance
• Retirement Plan
• Paid Vacation & Sick Time
• Employee Wellness Programs
• Employee Gyms
  
  

To view the complete benefits information, please visit https://www.garfield-county.com/human-resources/benefits-brochure/