Job Description

Job Description

APPLICANTS MUST BE PERMANENT IN THE FRAUD INVESTIGATOR CIVIL SERVICE TITLE OR IN A COMPARABLE TITLE ELIGIBLE FOR 6.1.9.

The DSS Accountability Office (DSS-AO) is responsible for protecting the integrity of social services programs administered by the New York City Department of Social Services (DSS) and ensuring that DSS complies with all statutory, regulatory, and contractual standards.

The Bureau of Fraud Investigations (BFI) is mandated to conduct investigations of individuals and organized groups allegedly attempting or committing fraudulent acts against the social service programs administered by HRA/DSS. The Medicaid Investigations Division (MID) is mandated to provide expanded levels of fraud detection, investigation and prevention to the New York State of Health (NYSOH) Market Place, the official enrollment and eligibility determination site for NYS Medicaid. SOS 366-a(2)(a). MID review cases identified as susceptible to fraud and examine Medicaid enrollee documents found in the HRA One Viewer database. Investigations are undertaken when the information provided by the enrollees is not reasonably compatible with federal and state data sources.

BFI is recruiting for three (3) Fraud Investigator II to function as Senior Investigators, who will:

- Conduct complex investigations into allegations of fraud, waste, and/or abuse of social services benefits administered by HRA and the City of New York. Cases are received from unit supervisors and are generated from data mining, anonymous sources, and other match reports.

- Perform fieldwork activity including interviews with clients, witnesses, and participants who are under investigation to verify documents and records and gather evidence to build solid cases against persons committing fraud.

- Conduct collateral interviews with employers, landlords, and other witnesses to secure information. Interact with other law enforcement agencies at Federal, State, and local levels as part of the investigative process.

- Access numerous resources, such as the Welfare Management System (WMS), LexisNexis, HRA Viewer, ACRIS, ACCIS, and Data Warehouse to conduct research and obtain vital information relevant to the investigation.

- Write detailed case notes and annotated reports summarizing chronological events and developments.

- Resolve allegations of fraud by making eligibility determinations or recommendations for continued assistance, case closings, or reduced assistance.

- Perform extensive fieldwork activity including interviews, undercover operations, surveillance and interrogations.

- Meet with Supervisor to discuss activities, concerns, and findings in investigations.

- Liaise between HRA, AO/IREA, and local law enforcements. Represent and testify on behalf of HRA in court and at Fair Hearings.

- Assist in the training of new investigative staff.

- Perform other duties as needed.

Work Location: 240-250-252 Livingston Street, Brooklyn

Hours/Schedule: Monday - Friday 9 am - 5 pm

Qualifications

1. A four-year high school diploma or its educational equivalent and three years of satisfactory, full-time experience, acquired within the United States in one or a combination of the following:

a . performing investigations involving criminal and/or fraudulent activities; or

b. evaluating credit histories; or

c. searching for assets; and/or

d. researching, compiling and/or locating evidence or information in order to build a case or uncover activities of a criminal, corrupt, unlawful or unethical nature involving public or private funds; or

2. An associate degree or 60 semester credits from an accredited college or university, including or supplemented by 12 semester credits from an accredited college or university in criminal justice, forensic auditing, forensic science, police science, criminology, criminal justice administration and planning, and/or law or a related field and one year of satisfactory, full-time experience as an investigator as described in 1 above; or

3. A baccalaureate degree from an accredited college or university; or

4. Education and/or experience equivalent to 1, 2 or 3 above. Undergraduate college credit can be substituted for experience on the basis of 10 semester credits from an accredited college or university, for three months of full-time experience. However, all candidates must have at least a four-year high school diploma or its educational equivalent.

Clerical experience in an organization which investigates criminal or fraudulent activities is not acceptable.

Additional Information

The City of New York is an inclusive equal opportunity employer committed to recruiting and retaining a diverse workforce and providing a work environment that is free from discrimination and harassment based upon any legally protected status or protected characteristic, including but not limited to an individual's sex, race, color, ethnicity, national origin, age, religion, disability, sexual orientation, veteran status, gender identity, or pregnancy.

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