Investigative Officer 2 (SIF)
Duties include, but are not limited to:
-Gathers and analyzes documentary evidence from various NYSIF departments, private investigator reports, police reports, payroll records, business records, medical records, financial records, and policyholder records to determine the validity of allegations. -Utilizes experience in complex and sensitive investigations which require an understanding of workers' compensation law. -Conducts database searches into people, corporations, liens, addresses and property ownership. Gathers public and private intelligence information to support the investigations. -Employs foot, stationary, and vehicle surveillance techniques to gather and record evidence in various formats. Conduct surveillance at worksites, private homes, and businesses belonging to claimants, doctors, and/or policyholders. -Interviews and obtains affidavits from subjects of investigations and witnesses, including employers, co-workers, witnesses to accidents, lawyers, physicians, hospital administrators or insurance executives. -Obtains documentary evidence concerning concealed employment and illicit activities including payroll records, receipts, contracts, and affidavits from employers. -Prepares narrative reports of investigations and surveillance. -Meets with prosecutors regarding case referrals and ongoing prosecutions, as well as high level fraud investigative and law enforcement officials to discuss topics relevant to workers compensation fraud prevention. -Utilizes investigative expertise and contacts within the prosecutorial community to effectively build a strong criminal case when appropriate. -Draft written reports and evidence summaries for presentation to a prosecutor for criminal actions or NYSIF legal for civil actions. -Assist lawyers, either prosecutors or NYSIF civil attorneys with the ongoing legal action, as well as the follow-up after conclusion /convictions. Testify as needed at trial, grand jury, civil litigation, or Worker's Compensation Board hearings. -Maintains professional contact with Legal counsel, other local, state and federal high-level insurance fraud officials, as well as private sector leaders and organizations to identify, investigate and assist in prosecution of healthcare fraud. Interacts with all levels of staff and management at NYSIF in the course of duties. -Maintains membership in and/or attends meetings of related fraud investigative organizations to keep abreast of trends and training. Participates in training opportunities to enhance investigative skills for the detection of claims fraud, policy fraud and medical provider fraud.
Job Function
Duties include, but are not limited to:
-Gathers and analyzes documentary evidence from various NYSIF departments, private investigator reports, police reports, payroll records, business records, medical records, financial records, and policyholder records to determine the validity of allegations. -Utilizes experience in complex and sensitive investigations which require an understanding of workers' compensation law. -Conducts database searches into people, corporations, liens, addresses and property ownership. Gathers public and private intelligence information to support the investigations. -Employs foot, stationary, and vehicle surveillance techniques to gather and record evidence in various formats. Conduct surveillance at worksites, private homes, and businesses belonging to claimants, doctors, and/or policyholders. -Interviews and obtains affidavits from subjects of investigations and witnesses, including employers, co-workers, witnesses to accidents, lawyers, physicians, hospital administrators or insurance executives. -Obtains documentary evidence concerning concealed employment and illicit activities including payroll records, receipts, contracts, and affidavits from employers. -Prepares narrative reports of investigations and surveillance. -Meets with prosecutors regarding case referrals and ongoing prosecutions, as well as high level fraud investigative and law enforcement officials to discuss topics relevant to workers compensation fraud prevention. -Utilizes investigative expertise and contacts within the prosecutorial community to effectively build a strong criminal case when appropriate. -Draft written reports and evidence summaries for presentation to a prosecutor for criminal actions or NYSIF legal for civil actions. -Assist lawyers, either prosecutors or NYSIF civil attorneys with the ongoing legal action, as well as the follow-up after conclusion /convictions. Testify as needed at trial, grand jury, civil litigation, or Worker's Compensation Board hearings. -Maintains professional contact with Legal counsel, other local, state and federal high-level insurance fraud officials, as well as private sector leaders and organizations to identify, investigate and assist in prosecution of healthcare fraud. Interacts with all levels of staff and management at NYSIF in the course of duties. -Maintains membership in and/or attends meetings of related fraud investigative organizations to keep abreast of trends and training. Participates in training opportunities to enhance investigative skills for the detection of claims fraud, policy fraud and medical provider fraud.
Salary Range:
From $67897 to $86140 Annually
Minimum Qualification
Minimum
Qualifications:
Promotion:
One year of permanent service as an Investigative Officer 1 (SIF). Non-competitive:
an associate's or bachelor's degree in criminal justice or related field, or five years of insurance claims investigation experience or professional investigation experience with law enforcement agencies, or seven years of professional investigation experience involving economic or insurance related matters. Related fields include:
law enforcement, police science, criminal justice administration, criminology, criminal investigation, police studies, public justice, forensic accounting, forensic psychology, forensic science, and economic crime management. Preferred
Qualifications:
Understanding of medical terminology and medical coding conventions (CPT, HCPCS, ICD10); Certified Professional Coder (CPC) or Certified Profissional Medical Auditor (CPMA); Accredited Healthcare Fraud Investigator (AHFI).Estimated Salary: $20 to $28 per hour based on qualifications.
-Gathers and analyzes documentary evidence from various NYSIF departments, private investigator reports, police reports, payroll records, business records, medical records, financial records, and policyholder records to determine the validity of allegations. -Utilizes experience in complex and sensitive investigations which require an understanding of workers' compensation law. -Conducts database searches into people, corporations, liens, addresses and property ownership. Gathers public and private intelligence information to support the investigations. -Employs foot, stationary, and vehicle surveillance techniques to gather and record evidence in various formats. Conduct surveillance at worksites, private homes, and businesses belonging to claimants, doctors, and/or policyholders. -Interviews and obtains affidavits from subjects of investigations and witnesses, including employers, co-workers, witnesses to accidents, lawyers, physicians, hospital administrators or insurance executives. -Obtains documentary evidence concerning concealed employment and illicit activities including payroll records, receipts, contracts, and affidavits from employers. -Prepares narrative reports of investigations and surveillance. -Meets with prosecutors regarding case referrals and ongoing prosecutions, as well as high level fraud investigative and law enforcement officials to discuss topics relevant to workers compensation fraud prevention. -Utilizes investigative expertise and contacts within the prosecutorial community to effectively build a strong criminal case when appropriate. -Draft written reports and evidence summaries for presentation to a prosecutor for criminal actions or NYSIF legal for civil actions. -Assist lawyers, either prosecutors or NYSIF civil attorneys with the ongoing legal action, as well as the follow-up after conclusion /convictions. Testify as needed at trial, grand jury, civil litigation, or Worker's Compensation Board hearings. -Maintains professional contact with Legal counsel, other local, state and federal high-level insurance fraud officials, as well as private sector leaders and organizations to identify, investigate and assist in prosecution of healthcare fraud. Interacts with all levels of staff and management at NYSIF in the course of duties. -Maintains membership in and/or attends meetings of related fraud investigative organizations to keep abreast of trends and training. Participates in training opportunities to enhance investigative skills for the detection of claims fraud, policy fraud and medical provider fraud.
Job Function
Duties include, but are not limited to:
-Gathers and analyzes documentary evidence from various NYSIF departments, private investigator reports, police reports, payroll records, business records, medical records, financial records, and policyholder records to determine the validity of allegations. -Utilizes experience in complex and sensitive investigations which require an understanding of workers' compensation law. -Conducts database searches into people, corporations, liens, addresses and property ownership. Gathers public and private intelligence information to support the investigations. -Employs foot, stationary, and vehicle surveillance techniques to gather and record evidence in various formats. Conduct surveillance at worksites, private homes, and businesses belonging to claimants, doctors, and/or policyholders. -Interviews and obtains affidavits from subjects of investigations and witnesses, including employers, co-workers, witnesses to accidents, lawyers, physicians, hospital administrators or insurance executives. -Obtains documentary evidence concerning concealed employment and illicit activities including payroll records, receipts, contracts, and affidavits from employers. -Prepares narrative reports of investigations and surveillance. -Meets with prosecutors regarding case referrals and ongoing prosecutions, as well as high level fraud investigative and law enforcement officials to discuss topics relevant to workers compensation fraud prevention. -Utilizes investigative expertise and contacts within the prosecutorial community to effectively build a strong criminal case when appropriate. -Draft written reports and evidence summaries for presentation to a prosecutor for criminal actions or NYSIF legal for civil actions. -Assist lawyers, either prosecutors or NYSIF civil attorneys with the ongoing legal action, as well as the follow-up after conclusion /convictions. Testify as needed at trial, grand jury, civil litigation, or Worker's Compensation Board hearings. -Maintains professional contact with Legal counsel, other local, state and federal high-level insurance fraud officials, as well as private sector leaders and organizations to identify, investigate and assist in prosecution of healthcare fraud. Interacts with all levels of staff and management at NYSIF in the course of duties. -Maintains membership in and/or attends meetings of related fraud investigative organizations to keep abreast of trends and training. Participates in training opportunities to enhance investigative skills for the detection of claims fraud, policy fraud and medical provider fraud.
Salary Range:
From $67897 to $86140 Annually
Minimum Qualification
Minimum
Qualifications:
Promotion:
One year of permanent service as an Investigative Officer 1 (SIF). Non-competitive:
an associate's or bachelor's degree in criminal justice or related field, or five years of insurance claims investigation experience or professional investigation experience with law enforcement agencies, or seven years of professional investigation experience involving economic or insurance related matters. Related fields include:
law enforcement, police science, criminal justice administration, criminology, criminal investigation, police studies, public justice, forensic accounting, forensic psychology, forensic science, and economic crime management. Preferred
Qualifications:
Understanding of medical terminology and medical coding conventions (CPT, HCPCS, ICD10); Certified Professional Coder (CPC) or Certified Profissional Medical Auditor (CPMA); Accredited Healthcare Fraud Investigator (AHFI).Estimated Salary: $20 to $28 per hour based on qualifications.
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