Investigative Auditor - Criminal Law Division - OAG

at Idaho Division of Human Resources in Boise, Idaho, United States

Job Description

State of Idaho Opportunity

Investigative Auditor, Medicaid Fraud Control Unit (MFCU), Criminal Law Division, OAG Closing Date: Open until filled. Start Date: To be determined upon hire. Salary: $44.60 – $49.06 hourly, DOE

The Medicaid Fraud Control Unit (MFCU) is currently accepting applications for an Investigative Auditor position. The federally funded and mandated MFCU is an interdisciplinary team dedicated to protecting vulnerable individuals and safeguarding the finite resources on which they depend. This position is responsible for conducting complex criminal investigations involving Medicaid provider fraud, patient abuse, neglect, and financial exploitation. Investigations often involve multi-agency coordination, detailed evidence analysis, and preparation for prosecution.

Primary duties include:

Conducting interviews

Obtaining and analyzing Medicaid claims

Reviewing healthcare provider information

Preparing detailed investigative reports and exhibits

Maintaining investigative case files

Testifying in court

Interfacing with other law enforcement and government agencies

Travel throughout Idaho

Minimum Qualifications:

Must have at least 5 years of professional auditing, financial analysis or investigative experience.

Above-average communication and interpersonal skills.

Ability to function as an integral part of an investigative team and work in a group setting.

Have enthusiasm for public service.

Strong working knowledge of Microsoft products such as Word and Excel.

Ability to analyze, interpret, and summarize complex financial and/or medical records.

Demonstrated experience in data analysis, medical auditing, or related investigative fields.

Must be able to drive and travel throughout Idaho.

Preferred Qualifications:

Bachelor’s degree in a field such as health information management, accounting, healthcare administration, or criminal justice.

Knowledge of the healthcare industry and medical coding concepts (CPT, ICD-10, DRGs) and/or experience with healthcare claims data.

Experience analyzing financial records, and/or medical records.

Proficiency in writing affidavits, subpoenas, and investigative reports.

Experience testifying in court or administrative hearings.

Knowledge of state and federal laws and regulations related to Medicaid, healthcare fraud, and abuse.

Certifications such as Certified Fraud Examiner (CFE), Certified Professional Coder (CPC), Certified Public Accountant (CPA), or Certified Professional Medical Auditor (CPMA).

Applications : E-mail a resume and cover letter to Keri.Ascherfeld@ag.idaho.gov.

Please contact Keri Ascherfeld with any questions: 208-334-4545 or Keri.Ascherfeld@ag.idaho.gov.

NOTE: You do not have to complete the standard application “apply now” process for this position. If you choose to do so, please also submit your resume to keri.ascherfeld@ag.idaho.gov to be considered for this position. The Idaho Office of the Attorney General is an equal opportunity employer. This position is exempt from state classified service, and the rules of the Division of Human Resources and the Idaho Personnel Commission. This is an at-will position. The State of Idaho is committed to access and reasonable accommodations for individuals with disabilities. If you require an accommodation at any step in our recruitment process, you are encouraged to contact Human Resources at (208) 334-4523 or email denise.stringer@ag.idaho.gov. Benefits: State employee benefits which include low-cost health and dental insurance, paid vacation and sick leave, 11 paid holidays, multiple retirement savings plans, flexible spending accounts, paid parental leave, and one of the nation’s best state retirement systems (PERSI). The Office is a qualifying employer for the Public Service Loan Forgiveness Program (PSLF). Ability to partially telecommute is also available for this position. To view full details and how to apply, please login or create a Job Seeker account

Salary : $45 - $49