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Healthcare Fraud Investigator

SGI Global, LLCOxford, MS

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Overview

Remote
On-site

Job Description

SGI is seeking a Healthcare Fraud Investigator to provide investigative support services at the United States Attorney's Office (USAO), Northern District of Mississippi, in Oxford, Mississippi. The Healthcare Fraud Investigator will support Assistant United States Attorneys (AUSAs) by conducting complex civil and administrative investigations involving healthcare fraud matters. Responsibilities include analyzing financial and medical records, conducting witness interviews, coordinating with federal and state agencies, and preparing detailed investigative reports. The position supports litigation activities and ensures the development of evidence necessary for successful case resolution.

Position is contingent upon award

Job Duties

  • Conduct thorough and systematic investigations into healthcare fraud and related civil or administrative violations
  • Work closely with AUSAs to plan investigative strategies, determine applicable laws, and identify potential violations
  • Analyze financial records, billing data, medical documentation, and other evidence to identify fraudulent activity
  • Initiate and maintain contact with federal, state, and local agencies, as well as witnesses and relevant parties
  • Conduct in-person and telephonic interviews to gather facts, obtain statements, and verify information
  • Develop and implement investigative plans, including identifying resources and methods for evidence collection
  • Coordinate with law enforcement agencies regarding subpoenas, warrants, and surveillance activities as needed
  • Utilize forensic and analytical tools to examine evidence, including electronic data and financial records
  • Organize, preserve, and manage documentary and physical evidence for litigation purposes
  • Prepare interim and final investigative reports summarizing findings, conclusions, and recommendations
  • Assist AUSAs in trial preparation, including compiling exhibits and developing charts, graphs, and other materials
  • Provide input on witness selection and ensure witness availability for hearings and trial proceedings
  • Testify in court regarding investigative findings, as required
  • Coordinate with stakeholders including courts, law enforcement agencies, and regulatory bodies
  • Perform other duties as assigned in support of litigation activities

Qualifications

  • Bachelor's Degree required
  • At least five (5) years of demonstrated experience conducting investigations related to healthcare fraud or similar matters
  • Experience analyzing complex financial and medical records
  • Ability to work independently and as part of a legal team in high-profile or sensitive investigations
  • Strong written and verbal communication skills, including report writing and courtroom testimony
  • Proficiency with investigative and legal research tools (e.g., LexisNexis, Westlaw, or similar systems)
  • Strong organizational and analytical skills
  • U.S. Citizenship required
  • Ability to obtain and maintain a high-risk background investigation (BI clearance)

SGI Global provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws.

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FAQs About Healthcare Fraud Investigator Jobs at SGI Global, LLC

What is the work location for this position at SGI Global, LLC?
This job at SGI Global, LLC is located in Oxford, MS, according to the details provided by the employer. Some roles may also include multiple work locations depending on the requirement.
What pay range can candidates expect for this role at SGI Global, LLC?
Employer has not shared pay details for this role.
What employment applies to this position at SGI Global, LLC?
The employer has not provided this information. This may be discussed during the hiring process.
What is the process to apply for this position at SGI Global, LLC?
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