Fraud Investigator

We need to output HTML fragment with sections: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. Only include sections that have real specific content. Must not repeat job title. Must not include metadata like Job ID. Must remove boilerplate, navigation, EEO, etc. Must preserve all substantive info. We need to parse the posting. Content: - About Peraton (company description) - maybe not needed? The instruction: "About Peraton" is company overview; but we need sections like About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. The "About Peraton" could be considered "About the role"? Actually "About The Role" heading appears in posting: "About The Role". So we should include that as a section heading

About the role

with content from that section. Then "What you'll do:" is responsibilities. So we can have

Responsibilities

with list of duties. Then "Essential Functions:" list of abilities - could be Requirements or Skills? Probably Requirements. Could also be Skills. We need to decide. Then "Qualifications Required Qualifications:" and "Desired Qualifications:" - that's Qualifications section. Then "Details Target Salary Range:" - Pay section. Then "Benefits Statement:" - Benefits section. Schedule: Not mentioned explicitly; maybe telework location list? Not schedule. There's no schedule info. So we should not include Schedule section. Skills: Could be derived from essential functions? Might be better to put essential functions under Skills? But we have both Requirements and Skills sections optional. We need to include only sections with real specific content. We have content for About the role, Responsibilities, Qualifications, Pay, Benefits. Also maybe Requirements (essential functions). We could treat essential functions as Requirements. Also we have "Telework-Ideally the candidate will be located in ..." maybe location but not schedule. Thus sections: About the role, Responsibilities, Requirements (essential functions), Qualifications, Benefits, Pay. We must not include Skills if not distinct; but we could include Skills if we have content like "Strong investigative skills, Strong communication and organization skills, Strong PC knowledge and skills". Those are in Required Qualifications. Could be placed under Skills. But we already have Qualifications section; we could split Required Qualifications into Requirements and Desired Qualifications into Qualifications? Hmm. Better to follow typical structure: About the role, Responsibilities, Requirements, Qualifications, Benefits, Pay. Skills maybe omitted if covered. We need to use

• for any list of duties/requirements/benefits. Use

  for prose. We must preserve ALL substantive information; do not invent or summarize away detail. So we need to include all details from those sections. Let's extract each. About the role: The paragraph after "About The Role": "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." That's the content. Responsibilities: The bullet list after "What you'll do:" includes many sentences. We need to turn each sentence into

• items? The instruction: Use
  • for any list of duties/requirements/benefits. So we should create a list where each duty is an
  • . The paragraph is long with many sentences separated by periods. We need to split into items preserving meaning. Could keep as one

    but instruction says use

    • for any list. So we should create list items for each duty. Let's parse responsibilities sentences: - The position is expected to perform high level complex investigations of medical professional service providers and develop cases for future action, including referral to law enforcement, education, over payment recovery 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 also 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. - Provide training and mentoring on tools/skills used in the investigative process - Develop expertise in a variety of tools to assist in the development of investigations and to participate in the identification of potential fraud schemes. - Telework-Ideally the candidate will be located in Maine, New Hampshire, Vermont, New York, Rhode Island, Connecticut, Massachusetts, Pennsylvania, Delaware, District of Columbia, New Jersey, Maryland, Northern Virginia. Note: The last bullet about telework location maybe belongs to responsibilities? It's more about location; but we can keep as responsibility? Might be better to treat as part of responsibilities? It's not a duty but a location preference. Could be placed under Requirements? But it's not a requirement; it's a preference. Might be omitted? But we must preserve ALL substantive information. So we need to include that sentence somewhere. Could be under Responsibilities as a note about telework location. Or we could create a separate section like "Location" but not allowed. We'll include it as a list item under Responsibilities. Now Requirements: Essential Functions list: - Ability to perform research and draw conclusions - Ability to organize a case file, accurately and thoroughly document all steps taken - Ability to present issues of concern, citing regulatory violations, alleging schemes or scams to defraud the Government - Ability to compose correspondence, reports and referral summary letters - Ability to communicate effectively, internally and externally - Ability to interpret laws and regulations - Ability to handle confidential material. - Ability to manage and prioritize workload effectively so that customer metrics are met or exceeded. - Ability to educate providers, provider associations, law enforcement, other contractors and beneficiary advocacy groups on program safeguard matters - Ability to work independently and as a member of a team to deliver high-quality work - Ability to attend meetings, training, conferences, overnight travel required. - This position may require the incumbent to appear in court to testify to work findings. We'll make each as
    • . Now Qualifications: Required Qualifications and Desired Qualifications. Required Qualifications: - 5 years with BS/BA or 9 years with a HS Diploma/equivalent - 5 to 6 years investigative experience - Strong investigative skills - Strong communication and organization skills - Strong PC knowledge and skills - US Citizenship is required Desired Qualifications: - 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 We'll put these under Qualifications section, maybe split into Required and Desired subheadings? But we only allowed headings: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. So we can have Qualifications heading and inside we can have

      for prose and maybe

      • for lists. We could separate Required and Desired using

        headings? Not allowed to create extra headings. Could just list all items with maybe a note. But we need to preserve distinction? The instruction: Preserve ALL substantive information; do NOT invent or summarize away detail. So we need to keep the distinction between required and desired. We could embed that in prose: e.g.,

        Required Qualifications:

        then list. But that adds bold tags not prohibited? Not mentioned. We can use inside

        . That's okay. Or we could have two

        lists with preceding

        describing. That's acceptable. Now Benefits: Benefits Statement: "Peraton offers eligible employees a variety of benefits including medical, dental, vision, life, health savings account, short/long term disability, EAP, parental leave, 401(k), paid time off (PTO) for vacation, and company paid holidays. A full listing of available benefits can be viewed at https://www.careers.peraton.com/benefits." We'll make a

        • for each benefit? Could list them as items. The sentence includes a list separated by commas. We'll split into items. Pay: Details 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." We'll put that as

          maybe with note about range. Schedule: Not present, so omit. Now we need to output only HTML fragment, no /, no markdown fences. Let's construct. We'll start with

          About the role

          then

          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.

          Then

          Responsibilities

          then
          with each
          • as above. Then

            Requirements

            then
            with essential functions. Then

            Qualifications

            then maybe

            Required Qualifications:

            ... then

            Desired Qualifications:

            ... Then

            Benefits

            then
            with benefits items. Then

            Pay

            then

            with salary range info. Make sure not to include any boilerplate like EEO, application statements, etc. Check for any duplicated lines: we must not repeat. Now let's craft list items precisely. Responsibilities items: 1. The position is expected to perform high level complex investigations of medical professional service providers and develop cases for future action, including referral to law enforcement, education, over payment recovery and other administrative actions. 2. Will work with internal resources and external agencies to develop cases and corrective actions as well as respond to requests for data and support. 3. An investigator uses good judgment and may work independently with minimum supervision and direction. 4. The investigator also 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. 5. An investigator handles multiple cas