Benefits Program Worker II - Fraud

Please see Special Instructions for more details.

• Fraud investigations require gathering objective evidence before making any determination. Describe the investigative methods you would use to collect, verify, and document evidence while ensuring your findings are fair, impartial, and supported by policy.
• Describe the investigative methods you would use when reviewing a potential fraud referral. How would you gather and evaluate evidence to determine whether additional investigation is warranted?

Position Information

Working Title of Vacant Position

Job Type

Job Type Full Time

Posting Type

Posting Type Public

Number of Vacancies

Number of Vacancies 1

Department

Department HUMAN SVCS

Division

Division HS-SOCIAL SERVICES ADMIN

Requisition Number

Requisition Number

Number of hours worked per week

Number of hours worked per week 40

Work Schedule

Monday – Friday 8 am – 5 pm .
Employees may be expected to work hours in excess of their normally scheduled hours in response to short-terms department needs and/or City-wide emergencies.

Work Site Location

Work Site Location Chesapeake, Va. (100 Outlaw Street)

Position Driving Requirement

Position Driving Requirement O - Occasional

Pay Grade

Pay Grade GE09

Pay Basis

Pay Basis Semi-Monthly

Advertised Salary

$50,607/ annually
Starting salary based on qualifications and experience

Job Description

Benefits Program Worker II – Fraud Investigator

The purpose of the position is to assist and support Chesapeake citizens in obtaining services provided by public and private agencies, and/or perform quality control for area of responsibility. The position is responsible for quality control and/or client assessment, investigating fraud, calculating overpayments, initiating Administrative or Court Action on all Intentional Program Violations, establishing overpayment and overseeing collections referrals, eligibility determination for financial and medical assistance, service delivery, and reporting. The position works within a general outline of work to be performed; develops work methods and sequences under general supervision.

ESSENTIAL TASKS
The tasks listed below are those that represent the majority of the time spent working in this position. Management may assign additional tasks related to the type of work of the position as necessary.

• Receives, evaluates and tracks allegations of suspected fraud;
• Conducts an inquiry and investigation into the allegation in an effort to determine intent or no intent on the part of the client in all program areas;
• Calculates overpayments when the overpayment is discovered through a fraud investigation.
• prepare reports; apply principles of persuasion and/or influence; document data from interviews, forms, and documents; and organize own work schedule
• Reviews all new policy and procedures; and stays a breast of federal, state, and local guidelines and regulations for area of responsibility.
• Interviews customer and conducts assessment of eligibility for services; explains available programs and services; assists with completion of application process.
• Dictates narrative of case; completes computer forms to establish case on various computer systems; analyzes available information and determines and recommends client eligibility.
• Examines public assistance records/cases for completeness and accuracy; reviews accounts payable to ensure accuracy and timeliness of assistance payments.
• Performs routine office tasks such as typing correspondence, data entry, filing, telephoning, faxing, and photocopying; maintains record system for area of responsibility.
• Attends staff, team, committee, and other professional meetings to exchange information; meets with general public and community organizations to discuss programs for area of responsibility.

TYPICAL TASK :

• Receives referrals of suspected fraud form program workers and other sources including community complaints (anonymous or not) and computer matches.
• Analyzes allegations(s) and identifies the program regulations(s) which has been violated.
• Demonstrated ability to: communicate effectively both orally and in writing; perform addition, subtraction, multiplication, and division; calculate overpayments and track payments;
• Gathers and analyzes evidence to substantiate that fraud has or has not occurred. Testify in court proceedings; establish and maintain effective working relationships with clients, associates, law enforcement, other agencies and others;
• Conducts witness and suspect interviews and takes statements as appropriate.
• Work independently; analyze data, recognize gaps and collect information; draw legal and supportable conclusions;
• Establishes intent, if it exists. Determines suitability of cases for the Administrative Disqualification Hearing ( ADH ) processor for prosecution based on guidelines provided by the local Commonwealth’s Attorney.
• Prepares comprehensive investigative reports. Testifies in court or presents evidence at ADH’s. Maintains appropriate record and files. Compiles statistical information and creates reports as required.

Required Qualifications

VOCATIONAL / EDUCATIONAL REQUIREMENT : Requires any combination of education and experience equivalent to a bachelor’s degree in accounting, sociology, or a closely related field.

EXPERIENCE REQUIREMENT : In addition to satisfying the vocational/education standards, this position requires a minimum of one year of related, full-time equivalent experience.

SPECIAL CERTIFICATIONS AND LICENSES : Depending on departmental operational requirements, may require valid driver’s license and driving record in compliance with City Driving Standards

SPECIAL REQUIREMENT : Employees may be expected to work hours in excess of their normally scheduled hours in response to short-terms department needs and/or City-wide emergencies. Emergency operations support work and work locations may be outside of normal job duties.

Preferred Qualifications

• Three or more years of experience working directly with Virginia Division of Social Services Benefit Programs and/or Child Care Programs.
• Knowledge of investigative techniques; public assistance programs, legal proceedings, collection methods; applicable laws, codes
• Knowledge of Virginia Division of Social Services Benefit Program Fraud policies and procedures including civil and court procedures.
• One year of SPIDeR, VaCMS, DMIS , and MMIS experience in determining Eligibility in the In-take/On-Going unit

Job Open Date

Job Open Date 08/07/2026

Job Close Date

Job Close Date 08/23/2026

Open Continuous No

Special Instructions to Applicants

• Fraud investigations require gathering objective evidence before making any determination. Describe the investigative methods you would use to collect, verify, and document evidence while ensuring your findings are fair, impartial, and supported by policy.
• Describe the investigative methods you would use when reviewing a potential fraud referral. How would you gather and evaluate evidence to determine whether additional investigation is warranted?

ADA Checklist

Overall Physical Strength Demands

Overall Physical Strength Demands