Commonwealth of Kentucky - Franklin County, KY

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Minimum Requirement - Primary Education :
Graduate of a college or university with a bachelor's degree (which includes twenty semester hours or thirty quarter hours in accounting).

Minimum Requirement - Primary Experience :
Must have four years of accounting, auditing, investigative, management or computer science experience.

Education Substitution :

Experience Substitution :
Certification as Certified Public Accountant will substitute for the required education and three years of the required experience.

Special Requirements :

Description of Job Duties
Main Duties: Provide Professional Support to the MFCU Investigation Function through the Expert Compilation & Analysis of Claims Data & the Exam of Other Records Obtained; Other Duties as Assigned by Management

Professionally Utilizes All Available Steps to Compile & Analyze Medicaid Claims Data to Identify Criminal Acts Committed by Providers of Medicaid Services

Identifying & Extracting Questionable Claims Data & Out- Liers from the Medicaid Claims Data System

Compiles Accurate Claims Data in Response to Request Associated With NAMFCU Global Investigations & Reports in a Timely Manner

Provides Expert Exam of Evidence Seized by MFCU Investigators & Compares That Information to Claims Data for the Purpose of Identifying Improper Medicaid Reimbursements

Prepares Comprehensive Written Reports Which Accurately Detail Findings Associated With Claims Data Analysis

Maintains a Running Account of Overpayments due & Paid to the Commonwealth of Kentucky In Connection with Medicaid Fraud Investigations/Prosecutions

Serves as Administrator of the MFCU Case Management Software; Other Duties as Assigned By Management.

Selection Method :
Qualifying: All candidates who apply and meet the minimum requirements are eligible for placement on the register for hiring consideration.

Group :

Characteristics of the Class :
Plans and conducts investigations involving the examination of financial records and other related records to determine whether violations of policies, rules, regulations and laws have occurred; and performs other duties as required.

Typical Working Conditions and Unique Physical Requirements :
Typically works in an office setting. Occasional travel may be required.

Additional Requirements :
Applicants and employees in this classification may be required to submit to a drug screening test and background check.

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