Investigative Auditor - Medicaid Fraud

Office of the Attorney General

Department of Law

Medicaid Fraud - Investigative Auditor

*To move forward in the recruiting process ALL applicants are required to:

·         Attach a current Resume

·         Cover Letter

·         Attach "Department of Law Employment Application" (click link to obtain: http://law.georgia.gov/careers/application-forms) 

·         Attach copies of official undergraduate transcripts (unofficial accepted during application process)

·         If the file is too large to attach please email the document(s) to hr@law.ga.gov to include the position title - application material(s) in the subject line.

The mission of the Department of Law is to serve the citizens of the State of Georgia by providing legal representation of the highest quality to the agencies, officers and employees of state government and by honorably and vigorously carrying out the constitutional and statutory responsibilities of the Attorney General.  The position filled through this announcement will serve within the Audits section of the Medicaid Fraud Division.

Job Summary

Assists in performing various audit and financial investigative procedures on Medicaid providers suspected of having committed Medicaid fraud or abuse, which includes collecting, evaluating and analyzing data & other evidence, preparing analyses, identifying the amounts and types of fraud, preparing trial exhibits such as graphs, charts, reports, etc., and serving as an expert witness during the prosecution of Medicaid fraud cases.  Works as part of a multi-disciplinary team, which typically includes a prosecutor, investigators, an auditor, a nurse investigator, and an intelligence analyst. 

Duties & Responsibilities

• Obtains and maintains comprehensive knowledge of operations and reimbursement policies of Medicare and Medicaid programs.
• Works with investigative team to plan the financial and audit strategy for criminal and civil fraud investigations.
• Participates in meetings throughout an investigation to discuss various aspects of the case.
• Analyzes data and summarizes findings on audit procedures and financial matters related to the case.
• Collects, evaluates and analyzes evidence obtained during the course of an investigation and forms conclusions based on the analyses; Prepares the necessary papers to document the results of the analyses and the conclusions formed.
• Assists in conducting search warrants and handling evidence in accordance with Unit policy.
• Prepares analyses identifying the amounts and types of fraud; Prepares written report that summarizes the conclusions reached during an investigation.
• Prepares trial exhibits such as analyses, graphs, reports, etc. The trial exhibits should help judges and/or jury members better understand the testimony given.
• Serves as a summary witness during the prosecution of alleged Medicaid fraud cases, as well as grand jury proceedings, motion hearing, and sentencing hearings.
• Other duties as assigned

The above statements are intended to describe the general nature and level of work being performed by persons assigned to this title.  They may not include all job duties performed by employees on this job title, and every position does not necessarily require these duties.

Minimum Qualifications

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

Preferred Qualifications:

In addition to meeting the minimum qualifications, meet one or more of the following:

·         Audit experience in medical claims and/or claims data.

·         Certification as a CPA or a CFE (Certified Fraud Examiner).

Additional Information:

A criminal background check is completed on all candidates; employment is also contingent upon the completion and satisfactory results of the background investigation. Candidates that are being strongly considered for the position will also be required to submit a Department of Law employment application & waiver, Georgia Department of Revenue Tax Clearance letter and copies of official college transcripts.

Due to the volume of applications received, we are unable to provide information on application status by phone or e-mail.  All applicants will be considered, but may be screened for the preferred qualifications of the position, and may not necessarily receive an interview. 

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