Workers Compensation Analyst

Location: Warrendale, Pennsylvania, United States
Date Posted: 06-15-2014
OIG Workers Compensation Analysts (WCAs) provide local investigative support to OIG Special Agents investigating two types of suspected workers compensation fraud: claimant fraud and medical provider fraud. Special Agents work closely with the Postal Service’s District Health and Human Resource Management (HRM) and U.S. Department of Labor (DOL) – Office of Workers’ Compensation Programs (OWCP) offices, Postal Service management, and others to proactively detect instances of suspected fraud and resolve allegations that have been brought to their attention. Investigations are typically lengthy, labor intensive, and involve complex issues.

Duties:
 
a. Review/analyze applicable employment and medical data maintained by DOL, Postal Service, and other related sources to gather information and evidence related to the possible loss of postal funds and/or assets within the Injury Compensation (IC) Program. Note: The WCA’s review is limited to gathering information and evidence. WCA’s are prohibited from performing or commenting on the claims management duties of the IC specialists. Perform physical and technologically-assisted surveillances.
b. Analyze data using computer systems and software to obtain and process information for the purpose of identifying suspected loss of postal funds and/or assets within the IC Program.
c. Support OI’s agents by interviewing potential witnesses;
d. Work with USPS personnel assigned to safety, health and injury compensation, the USPS OIG, DOL-OWCP claims examiners, and other federal, state, and local agencies to gather information and evidence related to the possible loss of postal funds and/or assets within the IC Program.
e. Request/perform criminal history, driver’s license, and/or insurance company record checks.
f. Conduct potential witness interviews, including public and private sector employees and employers, and others to secure and document information and evidence of suspected loss of postal funds and/or assets within the IC Program. Note: Unaccompanied interaction and interviews with potential witnesses will be limited to obtaining subject background information and information in support of the WCA’s surveillance activity. WCAs may conduct witness interviews of USPS employees at the direction of the case agent /agent, but are not required to be accompanied by the agent. However; WCAs must be accompanied by the case agent/agent when conducting formal interviews of non-USPS personnel.
g. At the direction and in coordination with the COR or case agent/agent, conduct physical and/or technologically-assisted surveillance activities of suspect claimants.
h. Make detailed oral and written reports of findings to the case agent/agent. Prepare other written reports and correspondence as required.
i. At the direction and in coordination with the COR or case agent/agent, conduct cameo appearances.
j. Prepare detailed written reports on completed tasks/activities
k. Provide oral or written testimony at administrative and judicial hearings, civil, and criminal court proceedings as required

Requirements:
 
a. Prior law enforcement experience (minimum 5 years), including experience conducting physical and electronic surveillances and interviews.
b. Knowledge of the laws of evidence.
c. Strong analytical skills, including the ability to analyze documents and elicit factual information.
d. Strong computer skills.
e. Ability to take comprehensive notes and generate detailed technical and non-technical reports based on the notes taken.
f. Good organizational and time management skills.
g. Good human relations skills, including the ability to communicate orally sufficient to express thoughts to a variety of people.
h. Ability to work on weekdays and during irregular and unusual hours, including evenings, late nights, weekends, and holidays, as necessary, and at the designated hourly rate, without any additional premium pay (overtime pay, compensatory time off; Sunday pay, night pay differential, and holiday premium pay).
i. Ability to travel extensively and for extended periods of time, as needed, with little or no advance notice or preparation.
j. A valid driver’s license.
k. U.S. citizen.







 
Please direct any questions to careers@nhrglobal.com.  NHR Global is an equal opportunity employer.  
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