Fraud Investigation Manager jobs in Rochester, NY

Investigation Audit Specialist - Arc GLOW, Batavia, NY

This position is responsible for maintaining an organized effective working environment. This will include performing duties as assigned in the areas of Quality and Corporate Compliance, including but not limited to internal quality assurance and billing audits, incident or compliance investigations, record retention and organization, and Administrative Support for the Department.

ESSENTIAL FUNCTIONS:

General:

• Incorporate the agency’s mission and vision in the performance of all job duties
• Respect people’s right to privacy by ensuring confidentiality under HIPAA requirements and agency policies
• Maintain positive customer relations
• Represent Arc GLOW in a professional manner
• Adhere to all agency policies and procedures
• Ensure maintenance and safekeeping of all records with respect to confidentiality, fire and theft
• Develop and maintain cooperative relationships with all staff and authorizing external agencies
• Attend meetings and training as assigned
• Participate on agency committees as assigned
• Perform other duties as assigned by Corporate Compliance management team

Quality Assurance and Compliance:

• Conduct Agency Investigations as assigned, in accordance with all requirements
• Prepare and submit timely investigation reports within required regulatory timelines
• Work with other agency incident investigators as needed, to ensure required time lines are met and records are current
• Participate in improvement of investigation processes, and other quality improvement initiatives assigned by Compliance / Quality management team
• Prepare / gather documentation for internal trend reports and external auditing purposes as requested
• Effectively update databases as assigned by Compliance / Quality management team
• Conduct Agency Internal Audits as assigned in accordance with all requirements

NON-ESSENTIAL FUNCTIONS:

• Provide staff training as deemed appropriate
• Participate in agency events
• Develop or revise tools necessary to fulfill department functions
• Assist with the maintenance of agency and department policies and procedures

REPORTING RESPONSIBILITIES:

Reports to: Quality Assurance Coordinator

KNOWLEDGE, SKILLS AND ABILITIES:

• Knowledge of oversight entities and regulatory requirements
• Strong oral and written communication skills
• Understanding of and appreciation for diversity
• Strong interpersonal skills
• Strong computer skills, including database entry and reporting
• Strong organizational skills
• Experience conducting investigations a plus
• Conscientiousness, dedication, self-discipline, and a sense of responsibility
• Function successfully with general direction
• Ability to work independently, take initiative and prioritize multiple assignments with attention to detail and deadlines in a high volume, stressful environment.
• Ability to establish effective relationships and work in a team environment to meet team and agency goals
• Ability to exercise discretion in handling confidential and / or sensitive information

PHYSICAL REQUIREMENTS;

• Ability to use standard office equipment including personal computer, phone, fax, copier, etc.
• Ability to speak and listen
• Ability to sit or stand for extended periods of time
• Ability to sit, stand, stoop, climb, push and pull
• Ability to lift up to 30 lbs.

WORKING CONDITIONS:

• Working conditions are generally normal for an office environment.
• Will be required to travel to offsite locations.
• Occasional work in a warehouse environment, which may include dirty, musty, hot or cold conditions

MINIMUM QUALIFICATIONS:

• Associates Degree in Human Services or Criminal Justice (or related field) preferred OR
• Three (3) years’ experience in the performance of activities relating to Human Services and / or working with individuals with developmental disabilities
• Valid NYS Driver’s License with safe driving record per agency policy

Job Type: Full-time

Pay: $19.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Day shift
• Monday to Friday

Ability to Relocate:

• Batavia, NY: Relocate before starting work (Required)

Work Location: In person