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Auditor - Medicaid Fraud Division

2 months ago

Atlanta, Georgia, United States GeorgiaGov Full time

Job Summary

The GeorgiaGov is seeking a highly skilled Investigative Auditor to join our team in the Medicaid Fraud Division. As an Investigative Auditor, you will play a critical role in detecting and preventing Medicaid fraud, ensuring the integrity of our healthcare programs.

Duties & Responsibilities

  • Develop and maintain comprehensive knowledge of operations and reimbursement policies of Medicare and Medicaid programs.
  • Collaborate with investigative teams to plan financial and audit strategies for criminal and civil fraud investigations.
  • Participate in meetings throughout an investigation to discuss various aspects of the case.
  • Analyze data and summarize findings on audit procedures and financial matters related to the case.
  • Collect, evaluate, and analyze evidence obtained during the course of an investigation and form conclusions based on the analyses.
  • Assist in conducting search warrants and handling evidence in accordance with Unit policy.
  • Prepare analyses identifying the amounts and types of fraud; Prepare written reports that summarize the conclusions reached during an investigation.
  • Prepare trial exhibits such as analyses, graphs, reports, etc. The trial exhibits should help judges and/or jury members better understand the testimony given.
  • Serve as a summary witness during the prosecution of alleged Medicaid fraud cases, as well as grand jury proceedings, motion hearings, and sentencing hearings.
  • Perform other duties as assigned.

Requirements

Minimum Qualifications

  • Bachelor's degree from an accredited college or university with a major in accounting or a related field.

Preferred Qualifications

  • Audit experience in medical claims and/or claims data.
  • Certification as a CPA or a CFE (Certified Fraud Examiner).