COMPLIANCE INVESTIGATOR 1/2/3

Office of Workers’ Compensation Division: Fraud Claims Location: East Baton Rouge

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The Compliance Investigator 1/2/3 will conduct independent investigations of suspected workers’ compensation fraud and violations of state and federal laws, agency policies, and regulations. The position analyzes claims, payroll records, public records, and electronic databases to identify irregularities, determine involvement, and develop cases. Responsibilities include gathering and preserving evidence, documenting findings, preparing cases for prosecutorial referral, and maintaining confidential investigative records in accordance with applicable statutes.

The Office of Workers’ Compensation Administration (OWCA) in Louisiana oversees the enforcement and administration of workers’ compensation laws, aiming to support early return-to-work efforts and improve workplace safety. The department manages disputed claims, conducts hearings, reviews medical treatment disputes, and investigates fraud through collaborative efforts like the GAME ON task force.

AN IDEAL CANDIDATE WILL POSSESS THE FOLLOWING COMPETENCIES:

• Communicating Effectively: The ability to convey information, ideas, and emotions using structured communication methods that promote understanding and engagement.
• Following Policies and Procedures: The ability to follow, reinforce, adapt, or develop policies and procedures to maintain compliance with federal and state legal requirements, State Civil Service rules, and organizational policies.
• Thinking Critically: The ability to analyze information objectively, identify connections across sources, and form logical, well-supported conclusions.

Three years of experience in accounting, auditing, administrative services, building inspection, real estate appraisal, law enforcement, investigations, or in the issuance or recommendation of medical licenses; OR

Six years of full-time work experience in any field; OR

A bachelor's degree.

EXPERIENCE SUBSTITUTION: Every 30 semester hours earned from an accredited college or university will be credited as one year of experience towards the six years of full-time work experience in any field. The maximum substitution allowed is 120 semester hours which substitutes for a maximum of four years of experience in any field. The official job specifications for this role, as defined by the State Civil Service, can be found here. Job Details:

• Monitor timeliness of responses and makes recommendation to supervisor for appropriate penalty assessment based upon research conducted to determine total number of employees and length of time employer has been determined non-compliant utilizing internal and external data sources.
• Analyze evidence and determine if further criminal or civil action is needed.
• Responsible for contacting employers in Louisiana to determine compliance with workers' compensation laws.
• Draft comprehensive investigative reports, for regulatory submission, to document findings and present information to senior management.
• Review Electronic Data Processing (EDP) generated cross-match cases and determine whether further investigation is warranted.
• Issue subpoenas duces tecum when requests for information are ignored.

Position-Specific Details: Location: Baton Rouge, La Appointment Type: Probational / Job Appointment / Promotional / Detail to Special Duty

Career Progression Group: Compliance Investigator 1, 2, or 3

Please click on the links below to learn more about each job level: Compliance Investigator 1 Compliance Investigator 2 Compliance Investigator 3

How to Apply:

No Civil Service test score is required in order to be considered for this vacancy.

To apply for this vacancy, click on the “Apply” link above and complete an electronic application, which can be used for this vacancy as well as future job opportunities. Applicants are responsible for checking the status of their applications to determine where they are in the recruitment process. Further status message information is located under the Information section of the Current Job Opportunities page.

• Information to support your eligibility for this job title must be included in the application (i.e., relevant, detailed experience/education). Resumes will not be accepted in lieu of completed education and experience sections on your application. Applications may be rejected if incomplete.

All applicants selected for employment must submit to drug screening and a background check.

Contact Information: For further information about this vacancy, contact: Kedrick Kennedy [email protected]

Louisiana Works is an equal employment opportunity employer and SAME agency that serves as a model employer for the recruitment, hiring, and retention of individuals with disabilities. Auxiliary aids and services are available upon request to individuals with disabilities • TDD# 800-259-515