Job Details
Auditor IV – Medicaid Provider Fraud
This listing closes on 3/8/2021 at 5:00 PM Eastern Time (US & Canada).
Salary
$40,759.00 – $75,413.00 Annually
Location Richland County, SC
Richland County, SC
Job Type
FTE – Full-Time
Agency
Attorney General’s Office
Job Number
110574
Closing date and time
3/8/2021 at 5:00 PM Eastern Time (US & Canada)
Agency Specific Application Procedures:
Applications accepted via NeoGov
Class Code:
AD12
Position Number:
60009572
Normal Work Schedule:
Monday – Friday (8:30 – 5:00)
Pay Band
Band 6
Opening Date
02/25/2021
EEO Statement
Equal Opportunity Employer
Job Responsibilities
Unique analyst position functions as a member of multi-disciplined team, consisting of attorneys, investigators, and administrative support, in investigating alleged fraud conducted by Medicaid providers. Receives hotline calls and conducts initial review of referrals from various sources, interprets information from an investigative perspective utlizing healthcare billing data and other resources available. Compiles information into a report format while consulting with other MFCU staff within a team setting to assist with decisions relating to case openings, closures, or outside referrals. Position will require working with investigators and staff attorneys in becoming familiar with common provider fraud schemes to aide in the intake process. Will also participate in investigations into vulnerable adults being financially exploited. Will develop an understanding and knowledge of the laws, regulations and procedures that govern the SC Medicaid program. Participates and offers strategy in investigative team discussions. Extracts billing data from South Carolina Medicaid and prepares specific analyses. Utilizes data analysis and other resources to identify and communicate trends, patterns, or schemes. Examines financial records and Medicaid billing records to trace the source of fraud. Makes supported assessment of fraud damages and prepares spreadsheets to identify discrepancies. Presents data highlights, with insights, to both internal and external stakeholders. Assists external State and Federal agencies with data analysis. Collects, evaluates, and analyzes data and other evidence. Prepares exhibits for use in trial. Provides courtroom testimony. Collaborates with other states in working on cases with national impact. Assists Unit Director with financial reporting and budget documents; general unit performance tracking, statistics and reporting; and other required duties as requested. Participates in trainings and networking/outreach events.
An employee of the Office of the Attorney General will receive an attractive benefits package, opportunities for further training, and the chance to advocate for South Carolina’s future.
Who We Are:
The Office of the Attorney General is a historic state agency focused on upholding the rule of law and protecting the citizens of South Carolina. From its founding in 1698 to present day, the Office of the Attorney General has played an integral part in shaping the history of South Carolina. We are not just looking for someone to be a part of South Carolina’s history; we are seeking someone who will be an advocate for South Carolina’s future. Employees can expect to work in a unified environment on challenging and meaningful work. All staff receives an attractive state government benefits package and opportunities for further training and growth opportunities. Join the Office of the Attorney General in protecting the Constitution and serving the citizens of South Carolina.
Minimum and Additional Requirements
Bachelor’s degree and 3 years professional experience in accounting, auditing, finance, insurance, statistical or data analysis. Successful completion of required skills assessment during the interview process.
Preferred Qualifications
Required:
- Proficiency in Excel and Access
- Ability to communicate technical information to non-technical audiences, both orally and in writing/visuals
- Ability to identify and recognize data patterns and quantify potential issues
- Experience in analyzing financial documents
- Ability to develop investigative strategies
- Ability to work on a team
- Self-motivated
- Ability to foster a collegial work environment
- Strong organizational skills
Preferred:
- Experience conducting a white collar and/or healthcare fraud investigations or administrative reviews
- Knowledge of healthcare terminology and coding systems such as ICD 9/10, CPT, and HCPCs
- Certified Fraud Examiner
- Familiarity with Truven, SAS, MMIS, bank scan, or other similar software software
- Prior law enforcement and/or healthcare administration experience.
- Knowledge of statistical sampling techniques
Additional Comments
DRUG SCREENING, CREDIT CHECK, DELINQUENT TAX CHECK AND SLED BACKGROUND CHECKS REQUIRED.
THIS OFFICE IS AN EQUAL OPPORTUNITY AND AFFIRMATIVE ACTION EMPLOYER.
EEOP Utilization Report Available Upon Request
Benefits for State Employees
The state of South Carolina offers eligible employees generous benefits, including health and dental insurance; retirement and savings plan options; and paid vacation and sick leave. Plus, work-life balance programs such as telecommuting and flexible work schedules are available to employees of some state agencies.
Insurance Benefits
Eligible employees may enroll in health insurance, which includes prescription coverage and wellness benefits. Other available insurance benefits include dental, vision, term life insurance, long term disability and flexible spending accounts for health and child care expenses.
Retirement Benefits
State employees are also offered retirement plan options, including defined benefit and defined contribution plans. Additionally, eligible employees may elect to participate in the South Carolina Deferred Compensation Program, which is a voluntary, supplemental retirement savings plan offering 401(k) and 457 plan options.
Workplace Benefits
State employees may also be eligible for other benefits, including tuition assistance; holiday, annual and sick leave; and discounts on purchases, travel and more.
Note: The benefits above are available to most state employees, with the exception of those in temporary positions. Employees in temporary grant and time-limited positions may be eligible for all, some or none of these benefits as benefits are associated with each position type. For these positions, contact the hiring agency to determine what benefits may be available.
01
Do you have a Bachelor’s degree and three years professional experience in accounting, auditing, finance, insurance, statistical or data analysis.
- Yes
- No
02
A resume may be attached, but not substituted for completing the work history, education and reference sections of the employment application. Incomplete applications will not be considered. Is your application complete?
- Yes
- No
* Required Question
Agency State of South Carolina Phone 803-734-3970
Agency Attorney General’s Office Address 1000 Assembly Street, Dennis Bldg.
Columbia, South Carolina, 29201
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