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.
BOOKKEEPING AND ACCOUNTING
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.