Maximus is looking for a Heightened Scrutiny Reviewer at the Maximus Brownsville, TX location. The Heightened Scrutiny Reviewer for the E-rate Program researches and analyzes program transactions to identify potential program violations and / or fraud risks.

This position is an on-site position-all work will be performed at the Maximus Brownsville, TX location. A minimum of 60 days prior work experience supporting E-Rate program with Maximus is required.

• Identifies, analyzes and compiles evidence for potential risk findings
• Examines records to detect and trace fraudulent transactions
• Demonstrates a comprehension of the underlying factors that motivate the commission of fraud
• Writes investigation reports and advises leadership of findings
• Performs ad-hoc analysis to identify trends and enhance fraud identification procedures
• Diagnoses problems and develop compelling, data-driven recommendations
• Works with the customer to support fraud identification; identifies and recognizes fraud schemes

Skills and Education :

• Bachelor’s degree from an accredited institution in fraud, security, audit or a related field, preferred
• Minimum 1year professional experience preferred in the areas of fraud, waste and abuse or auditing, preferred.
• Strong analytical skills, highly organized and detail oriented with the proven ability to multi-task
• Demonstrated experience in forensic transactions and / or auditing practices
• Excellent interpersonal skills, including verbal, written and presentation communication skills
• Excellent problem solving, conflict resolution and change management skills
• Certified Fraud Examiner certification preferred

Additional Requirements as per Federal Contract / Client :

Work must be performed in the United States

Other Requirements :

Candidates must be verified that they are not on any of the following lists :

https : / / www.treasury.gov / ofac / downloads / sdnlist.txt

https : / / www.bis.doc.gov / index.php / the-denied-persons-list

Job Summary

The Heightened Scrutiny Reviewer for the E-rate Program researches and analyzes program transactions to identify potential program violations and / or fraud risks.

Reviews are conducted in accordance with legal search regulations and include activities such as : analyzing financial information, collecting evidence and interviewing potential witnesses and suspects.

The HS Reviewer will analyze and compile findings either verbally and / or in writing to client and internal teams.

Education and Experience Requirements

Essential Duties and Responsibilities :

• Process health care provider’s enrollment applications and provider updates.
• Verify provider credentials through various government agencies and license boards.
• Review the accuracy of provider demographic and billing information.
• Communicate with providers to clarify or obtain missing information or documents, and various data entry functions.

Minimum Requirements :

High School diploma or equivalent with 2-4 years of experience.

MAXIMUS Introduction

Since 1975, Maximus has operated under its founding mission of Helping Government Serve the People, enabling citizens around the globe to successfully engage with their governments at all levels and across a variety of health and human services programs.

With more than 30,000 employees worldwide, Maximus is a proud partner to government agencies in the United States, Australia, Canada, Saudi Arabia, Singapore and the United Kingdom.

For more information, visit https : / / www.maximus.com.

As a large employer and Federal contractor, Maximus is subject to various vaccine mandates across our lines of business. Maximus is committed to complying with any applicable vaccine mandates.

The specific vaccine requirements for this position will be outlined throughout the selection process. Individuals who believe they may qualify for a medical or religious accommodation will have the opportunity to apply for an accommodation following an offer of employment.

EEO Statement : Active military service members, their spouses, and veteran candidates often embody the core competencies MAXIMUS deems essential, and bring a resiliency and dependability that greatly enhances our workforce.

We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country.

We’re proud of our connections to organizations dedicated to serving veterans and their families. If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you.

A committed and diverse workforce is our most important resource. MAXIMUS is an Affirmative Action / Equal Opportunity Employer.

MAXIMUS provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disabled status.

Last updated : 2024-03-22