Responsibilities SafeGuard Services (SGS), a subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse. We are looking to add a Fraud Investigator to our SGS team of talented professionals. What you'll do: The Fraud Investigator is expected to perform high level complex investigations of medical professional service providers and develop cases for future action, including referral to law enforcement and other administrative actions. Will work with internal resources and external agencies to develop cases and corrective actions as well as respond to requests for data and support. - An investigator uses good judgment and may work independently with minimum supervision and direction. - The investigator may work as part of a team, as there may be times when the investigator needs to work with state and/or federal investigators and other personnel. - An investigator handles multiple caseload assignments concurrently; organizes and analyzes complex evidentiary patterns; interviews and obtains statements from witnesses and others. - Investigators may also be required to complete complex investigative reports that apply regulations or rules to the program(s) affected by the behavior being investigated. There may also be times when the investigator will need to apply federal or state laws. - Investigators are expected to research and understand the relevant offenses being investigated; conduct efficient and effective investigations concerning those alleged offenses and detect or verify suspected violations; obtain information and evidence by observation, record examination, and interview. - Investigators then analyze the results of the investigation to ascertain if the allegations have been corroborated and work with others to determine the appropriate steps that need to be taken to address the issues. - As part of an investigation, the investigator will need to prepare correspondence; be objective and accurate and communicate with others with tact. - There may be times when investigators need to react to unplanned situations, be flexible in planning their activities and adopt effective courses of action. - As investigators will be working with health privacy information, they also must maintain confidentiality and understand all the laws, rules and regulations concerning health privacy. - Teleworking is available in Contiguous US. Qualifications Basic Qualifications: - 4 years with AS/AA; 2 years with BS/BA; 0 years with MS/MA; 6 years with HS Diploma/equivalent - Investigative experience - Strong investigative skills - Strong communication and organization skills - Strong PC knowledge and skills - US. Citizenship required The most competitive candidates will have: - Medicare Part C, Medicare Part D, or managed care experience - Preferred - Strong background in investigations. - Experience in reviewing claims for technical requirements, performing medical review, and/or developing fraud cases - Knowledge of investigative practices regarding healthcare providers. - Knowledge of Medicare and/or Medicaid programs and the rules, regulations, policies and procedures - Background in evaluating, reviewing and analyzing medical claims and records - Ability to learn and operate a variety of data systems, equipment and tools used in investigations Essential Functions: - This position may require the incumbent to appear in court to testify about work findings. - Ability to perform research and draw conclusions - Ability to present issues of concern, citing regulatory violations, alleging schemes or scams to defraud the Government - Ability to organize a case file, accurately and thoroughly document all steps taken - Ability to compose correspondence, reports and referral summary letters - Ability to educate providers, provider associations, law enforcement, other contractors and beneficiary advocacy groups on program safeguard matters - Ability to communicate effectively, internally and externally - Ability to interpret laws and regulations - Ability to handle confidential material. - Ability to report work activity on a timely basis. - Ability to work independently and as a member of a team to deliver high quality work - Ability to attend meetings, training, and conferences, overnight travel required. Peraton Overview Peraton is a next-generation national security company that drives missions of consequence spanning the globe and extending to the farthest reaches of the galaxy. As the world’s leading mission capability integrator and transformative enterprise IT provider, we deliver trusted, highly differentiated solutions and technologies to protect our nation and allies. Peraton operates at the critical nexus between traditional and nontraditional threats across all domains: land, sea, space, air, and cyberspace. The company serves as a valued partner to essential government agencies and supports every branch of the U.S. armed forces. Each day, our employees do the can’t be done by solving the most daunting challenges facing our customers. Visit peraton.com to learn how we’re keeping people around the world safe and secure. Target Salary Range $66,000 - $106,000. This represents the typical salary range for this position. Salary is determined by various factors, including but not limited to, the scope and responsibilities of the position, the individual’s experience, education, knowledge, skills, and competencies, as well as geographic location and business and contract considerations. Depending on the position, employees may be eligible for overtime, shift differential, and a discretionary bonus in addition to base pay. EEO EEO: Equal opportunity employer, including disability and protected veterans, or other characteristics protected by law.

• Perform secondary reviews of escalated alerts and make risk-based decisions on complex or high-risk cases. • Conduct cradle-to-grave investigations, including insider trading, high-dollar cases and potential fraud rings, ensuring detailed documentation and clear investigative conclusions. • Write and file Suspicious Activity Reports, Continuing Activity Reports, and State Regulatory Reports in accordance with applicable regulatory requirements. • Research and analyze activity across multiple accounts to identify links between individuals engaging in coordinated or suspicious behavior. • Review High Risk Logs and approve incoming wire requests in line with internal controls and compliance standards. • Respond to regulatory and law enforcement requests with accuracy, timeliness, and appropriate documentation. • Assist in developing and delivering Financial Crimes training sessions, mentoring new hires, and contributing to team meetings and operational projects as needed.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description This position is responsible for performing detailed fraud monitoring and investigation of moderate to complex account activity and client behavior analyses, which includes but is not limited to online banking, wires, ACH, Check, Debit/ATM, and external transfer activity, while ensuring that all department procedures are followed. - May perform general account handling functions such as close account determination, holds, restraints, etc. - Routinely contacts customers and other bank associates to confirm the legitimacy of high-risk transactions prior to occurrence and takes appropriate actions to mitigate the risk to the Bank and the Customer. - Document research findings and actions on cases for possible referrals for Suspicious Activity Reporting, Identity Theft Operations (ITO) and Suspected Financial Abuse. - Analyze fraud cases to identify possible trends and points of compromise and present case analysis to Senior Fraud Operations Analyst and/or Management when needed. - Perform role and responsibilities in adherence to compliance of bank and department operational policies and regulations. Qualifications - College Degree preferred. - 2-3 years work experience in similar setting with financial exposure preferred. - 2+ years of financial fraud prevention and detection experience preferred. Requirements - Analyze and monitor daily reports generated by various fraud detection tools. - Manage Alerts/Cases to ensure alerts and cases are handled timely and case details are documented accurately. - Use internal and external resources to obtain forensic evidence for investigative purposes. - Ensure investigations and resolutions comply with applicable laws, department procedures, Bank policy, and industry leading practices. - Process and analyze Electronic Funds Transfer (EFT) customer fraud claims according to regulatory guidelines. - Serve as branch support and provide guidance regarding unusual, suspected/confirmed fraud, or undesirable activity. - Contact and effectively communicate with customers via multiple channels to validate information and confirm authorization of transactions. - Escalate cases to the Fraud Investigations Unit when applicable. - Remain current with arising fraud trends and activities by attending networking workshops and/or training. - Assist Senior Fraud Operations Analyst and CFD Management in loss, prevention, detection and recovery analysis when needed. - Must be able to travel occasionally as part of the Disaster Recovery Team. - Must be able to work flexible work schedule that may include shift work (i.e late shift up to 8:30PM). - Adhere to and comply with applicable, federal and state laws, regulations and guidance, including those related to anti-money laundering. - Identify and report suspicious activity. Company Description

• Serves as the examiner in charge of Compliance Testing reviews assigned. • Work with the Senior Manager and Department Head to establish the objectives, scope, testing approach and sampling techniques to be utilized during testing. • Schedule and participate in any commencement and exit meetings with business/stakeholders for compliance reviews. • Develop and distribute Announcement and Documentation Request Memos for scheduled reviews. • Perform and oversee compliance tests conducted by Compliance Testing team members. • Meet with the business/stakeholders to ensure the factual accuracy of issues raised. • Prepare “Compliance Draft Review Reports” that summarize results, findings, and recommendations for proposed enhancements for issues noted. • Obtain adequate management action plans with respect to any findings. • Document findings and management responses/action plans in Archer. • Perform follow-up to ensure timely completion of corrective actions and validate closure of issues. • Perform Quality Assurance review of testing conducted by the Compliance Testing Team members. • Assist with the creation and maintenance of departmental Key Performance Indicators and Key Risk Indicators. • Assist with the development of the Annual Compliance Testing Plan. • Assist in the Annual Performance Evaluation of Team Members. • Provide thoughts on continued process improvements and updates to the Compliance Testing Methodology, Procedures and workpaper templates. • Stay informed of changing regulatory requirements and the firm’s business model that might impact the firm’s compliance framework and the Compliance Testing plan. • Complete all required compliance and other firm required training. • Maintain knowledge of and adhere to all applicable internal compliance policies and procedures and other internal policies and procedures applicable to the role.