Denver Human Services Fraud & Recovery Investigator

About Our Job

With competitive pay, great benefits, and endless opportunities, working for the City and County of Denver means seeing yourself working with purpose - for you, and those who benefit from your passion, skills and expertise. Join our diverse, inclusive and talented workforce of more than 11,000 team members who are at the heart of what makes Denver, Denver.

What We Offer

The City and County of Denver offers a competitive salary commensurate with education and experience. The budgeted salary range for this position is $25.57 - $31.96. We also offer generous benefits for full-time employees which include but are not limited to:

• A guaranteed life-long monthly pension, once vested after 5 years of service

• 457B Retirement Plan

• 140 hours of PTO earned within first year + 11 paid holidays, 1 personal holiday and 1 volunteer day per year

• Competitive medical, dental and vision plans effective within 1 month of start date

Location

The City and County of Denver supports a hybrid workplace model. Employees work where needed, at a job site several days a week and off-site as needed. In this position you can expect to work three days in the office and two days working from home. Employees must work within the state of Colorado on their off-site days.

What You'll Do

At Denver Human Services (DHS), we envision a healthy community where people are connected, supported, safe, and well. One in three people in Denver turn to DHS for support at all stages of life. Our employees help children, older adults, families, and individuals navigate social and economic pressures by connecting them to services and experts who support their overall well-being.

Denver Human Services is seeking a knowledgeable and detail-oriented individual to serve as a Fraud Claims Investigator on the Fraud and Recovery team within the Performance Improvement and Accountability Division (PIAD). In this role, you will conduct investigations, determine overpayments establishment, pursue intentional program violations and fraud, track collections, and review and refer cases and claims for civil, criminal and administrative proceedings for Human Services programs.

Additionally, the Fraud Claims Investigator:

• Calculates and establishes fraud claims for overpayments related to investigations, tax offsets, customer/state inquiries, and civil/criminal referrals. Overpayments are reviewed with the relevant program regulations and rules to assure that all overpayments meet the necessary regulatory requirements, completed timely, and identify liable parties

• Assures that all overpayment notifications are sent timely and, in a manner, consistent with program regulations

• Reviews investigations to determine relevant program rules and regulations, researches and applies program rules, calculates benefits, and creates fraud claims. Creates and mails correspondence to household citing relevant program rules. Responds to inquiries from clients, eligibility workers, and State/Federal agencies. Assures that all actions taken are properly documented in the Colorado Benefits Management System (CBMS)

• Reviews assigned fraud cases for "clear and convincing evidence" of violations of program rules and proof of fraud to determine if intentional program violations (IPV) is warranted. Is responsible for reviewing fraud cases and determines if civil/criminal action is appropriate

• Represents the agency in administrative hearings by preparing hearing materials and presenting the case to the Office of Administrative Courts. The Fraud Claims Investigator will prepare evidence, reviews cases with the Assistant City Attorney and complete civil and criminal referral forms and will serve as the expert witness on criminal cases accepted by the District Attorney's Office

• Recommends write-offs for non-collectable accounts within policy guidelines. Assists Legal with bankruptcies by placing overpayments in the proper non-collectible status while bankruptcy proceedings are on-going

• Reviews and processes incoming Repayment Agreements (RA) and verifies if the payment meets program-specific minimum collection requirements. Renegotiates repayment agreements, if applicable

• Monitors collections activities on fraud cases with overpayments and reaches out to clients with delinquent debt. Research client's employment history and wage data with the Department of Labor and Employment database. Renegotiates new payment plan. Determines best course of legal action: voluntary payments, tax intercepts, wage assignments, garnishments, and judgements

• Reviews all databases and systems to determine the best address and information of the client for collections purposes. Contacts the client to explain the legal obligation of the client regarding the overpayments. Maintains, organizes, and updates case files and assures that all actions are recorded in Colorado Benefits Management System (CBMS)

• Performs other duties as assigned

About You

What You'll Bring

We value diversity of ethnicity, race, socioeconomic status, sexual identity, gender, religion, language, ability, and experience and exemplify this through the makeup of our team at all levels. You'll be right at home here if you cultivate strong relationships and push yourself, your work, the people around you and Denver to the next level.

Our ideal candidate has some or all the following experience, skills, and characteristics:

• Extensive knowledge of high-level program groups (HLPG) rules and regulations including experience with program eligibility rules for Supplemental Nutrition Assistance Program (SNAP), Financial Assistance (FA), Temporary Assistance for Needy Families (TANF), Medical Assistance (MA), Child Care Assistance Program (CCAP), and/or other public benefits programs

• Previous experience in claims and/or collections

• Excellent customer service skills

• Ability to work independently

• Strong work ethic

Required Minimum Qualifications

• Education requirement: Graduation from high school or the possession of a GED, HiSET or TASC Certificate

• Experience Requirement: Five (5) years of experience determining eligibility for public assistance programs. Knowledge of program eligibility rules for Supplemental Nutrition Assistance Program (SNAP), Financial Assistance (FA), Temporary Assistance for Needy Families (TANF), Medical Assistance (MA), Child Care Assistance Program (CCAP), and/or other public benefits programs

• Education/Experience Equivalency: Additional appropriate education may be substituted for the minimum experience requirements

Application Deadline

Applications for this position are accepted on a rolling basis. Please submit your application as soon as possible to ensure consideration.

About Everything Else

Job Profile

CA3068 Fraud Claims Investigator

To view the full job profile including position specifications, physical demands, and probationary period, click here.

Position Type

Unlimited

Position Salary Range

$25.57 - $38.36

Starting Pay

Although the full pay range is listed above, the budgeted hiring range for this position is $25.57 - $31.96.

Agency

Denver Human Services

The City and County of Denver provides equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, national origin, sex, sexual orientation, gender identity, national origin, disability, genetic information, age, or any other status protected under federal, state, and/or local law.

It is your right to access oral or written language assistance, sign language interpretation, real-time captioning via CART, or disability-related accommodations. To request any of these services at no cost to you, please contact Jobs@Denvergov.org with three business days' notice.

Applicants for employment with the City and County of Denver must have valid work authorization that does not require sponsorship of a visa for employment authorization in the U.S.

For information about right to work, click here for English or here for Spanish.