Fraud Investigator Peraton United States, Virginia, Reston 1875 Explorer St (Show on map) Sep 03, 2026 Fraud Investigator

Job Locations US Requisition

ID 2026-170154

Position Category Business Controls Clearance No Clearance Required Responsibilities 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. What you'll do: 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, Hampshire, Vermont, York, Rhode Island, Connecticut, Massachusetts, Pennsylvania, Delaware, District of Columbia, Jersey, Maryland, Northern Virginia.

Qualifications Qualifications:

5 years with BS/BA; or 9 years investigative experience with high school diploma

Strong investigative skills

Strong communication and organization skills

Strong PC knowledge and skills

US Citizen The most competitive candidates will have: 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

Essential Functions:

Three to five years investigative experience preferred

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. Peraton Overview Peraton is a next-generation national security company that drives missions of consequence spanning the globe and extending to the farthest reaches of the galaxy. As the world's leading mission capability integrator and transformative enterprise IT provider, we deliver trusted, highly differentiated solutions and technologies to protect our nation and allies. Peraton operates at the critical nexus between traditional and nontraditional threats across all domains: land, sea, space, air, and cyberspace. The company serves as a valued partner to essential government agencies and supports every branch of the U.S. armed forces. Each day, our employees do the can't be done by solving the most daunting challenges facing our customers. Visit peraton.com to learn how we're keeping people around the world safe and secure. 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.

EEO EEO:

Equal opportunity employer, including disability and protected veterans, or other characteristics protected by law.