Healthcare Fraud Investigator

SGI Global, LLC • Oxford, MS • 4d ago

Oxford, MS, USA | Ability to obtain clearance | Full Time

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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