Benefits Program Worker II - Fraud

City of Chesapeake VA

Chesapeake, VA

JOB DETAILS
SKILLS
Accounting, Accounts Payable, Analysis Skills, Attorney, Childcare, Communication Skills, Community and Social Services, Compensation and Benefits, Computer Systems, Credit and Collections, Customer Relations, Data Analysis, Data Entry, Database Administration, Driver's License, Electricity, Employee Benefits, Explosives, Fax Machines, Fraud Investigation, Infectious Diseases, Intentional Programming, Investigative Reports, Law Enforcement, Legal, Machine Tool, Maintain Compliance, Medical Assistance, Multitasking, Operational Support, Presentation/Verbal Skills, Purchasing/Procurement, Quality Control, Record Keeping, Regulations, Reporting Skills, Service Delivery, Social Work, Sociology, Systems Maintenance, Team Player, Typing, Vasopressin
LOCATION
Chesapeake, VA
POSTED
2 days ago

Position Details

Position Information

Working Title of Vacant Position Benefits Program Worker II - Fraud Job Type Full Time Posting Type City Employees Only Number of Vacancies 1 Department HUMAN SVCS Division HS-SOCIAL SERVICES ADMIN Requisition Number 2026324 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 Chesapeake, Va. (100 Outlaw Street) Position Driving Requirement O - Occasional Pay Grade GE09 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.
  • Maintains Fraud Free database tracking system.
  • 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

Posting Detail Information

Job Open Date 07/08/2026 Job Close Date 07/15/2026 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?
  • Please note: Selected candidate will be required to go out in the field and on home visits. *

ADA Checklist

Overall Physical Strength Demands

Overall Physical Strength Demands S=Sedentary - Exerting up to 10 lbs. occasionally or small weights frequently; sitting most of the time.

Physical Demands

C = Continuously- 2/3 or more of the time. F = Frequently- From 1/3 to 2/3 of the time. O = Occasionally- Up to 1/3 of the time. R = Rarely- Less than 1 hour per week. N = Never- Never occurs.

Standing Frequently- From 1/3 to 2/3 of the time. Sitting Frequently- From 1/3 to 2/3 of the time. Walking Frequently- From 1/3 to 2/3 of the time. Lifting Frequently- From 1/3 to 2/3 of the time. Lifting Amount Exerting up to 10 lbs Carrying Frequently- From 1/3 to 2/3 of the time. Carrying Weight Exerting up to 10 lbs Pushing/Pulling Frequently- From 1/3 to 2/3 of the time. Pushing/Pulling Weight Exerting up to 10 lbs Reaching Occasionally- Up to 1/3 of the time. Handling Occasionally- Up to 1/3 of the time. Fine Dexterity Frequently- From 1/3 to 2/3 of the time. Kneeling Occasionally- Up to 1/3 of the time. Crouching Rarely- Less than 1 hour per week. Crawling Rarely- Less than 1 hour per week. Bending Occasionally- Up to 1/3 of the time. Twisting Frequently- From 1/3 to 2/3 of the time. Climbing Occasionally- Up to 1/3 of the time. Balancing Rarely- Less than 1 hour per week. Vision Continuously- 2/3 or more of the time. Hearing Continuously- 2/3 or more of the time. Talking Continuously- 2/3 or more of the time. Foot Controls Continuously- 2/3 or more of the time. Machines, Tools, Equipment and Work Aids Used

Computer, copier, fax, telephone, scanner, adding machine, calculator, printer, car, and related equipment.

Protective Equipment Required

n/a

Health and Safety

D = Daily W = Several Times Per Week M = Several Times Per Month S = Seasonally N = Never

Mechanical Hazards N = Never Chemical Hazards N = Never Electrical Hazards S = Seasonally Fire Hazards S = Seasonally Explosives S = Seasonally Communicable Diseases S = Seasonally Physical Danger or Abuse S = Seasonally Other If Other, Description

Environmental Factors

D = Daily W = Several Times Per Week M = Several Times Per Month S = Seasonally N = Never

Dirt and Dust D = Daily Extreme Temperatures D = Daily Noise and Vibration D = Daily Fumes and Odors D = Daily Wetness/Humidity D = Daily Darkness or Poor Lighting D = Daily Primary Work Location Office Environment

Non-Physical Demands

C = Continuously- 2/3 or more of the time. F = Frequently- From 1/3 to 2/3 of the time. O = Occasionally- Up to 1/3 of the time. R = Rarely- Less than 1 hour per week. N = Never- Never occurs.

Time Pressures Continuously- 2/3 or more of the time. Emergency Situations Frequently- From 1/3 to 2/3 of the time. Frequent Change of Tasks Continuously- 2/3 or more of the time. Irregular Work Schedule/Overtime Occasionally- Up to 1/3 of the time. Performing Multiple Tasks Simultaneously Continuously- 2/3 or more of the time. Working Closely with Others as Part of a Team Continuously- 2/3 or more of the time. Tedious or Exacting Work Continuously- 2/3 or more of the time. Noisy/Distracting Environment Continuously- 2/3 or more of the time. Other If Other, Description Can anyone assist the employee in performing the primary tasks assigned to this position? If yes, identify the eligible task(s)

No

Professional References

Professional References

Please provide contact information for professional references.

Minimum Requests 0 Maximum Requests 4

Supplemental Questions

Required fields are indicated with an asterisk (*).

    • This position is for City employees, volunteers, temporary workers, and interns only. Are you currently a City of Chesapeake employee, volunteer, temporary worker, or intern? This information will be verified. Please update your application accordingly.
  • Yes

  • No

    • Do you possess a valid driver's license and a driving record that is in compliance with the City's Driving Standards? Please review link in posting for details.
  • Yes

  • No

Applicant Documents

Required Documents

  • Resume

Optional Documents

  • Transcripts
  • Letter of Recommendation

About the Company

C

City of Chesapeake VA