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Medicaid Fraud Investigator (8 positions)
North Carolina Dept of Justice
posted about 2 months ago
About the position
The Medicaid Fraud Investigator position at the North Carolina Department of Justice is a full-time role focused on investigating criminal and civil Medicaid fraud schemes, patient abuse, and misappropriation of recipient funds. The role involves conducting detailed financial analyses, preparing investigation reports, and collaborating with law enforcement and judicial personnel. The position is part of the Medicaid Investigations Division, which plays a crucial role in protecting taxpayer funds and ensuring access to medical services for Medicaid enrollees.
Responsibilities
- Conduct investigations into criminal and civil Medicaid fraud schemes, patient abuse, and misappropriation of funds.
- Perform detailed analysis of Medicaid and Medicare claims and reimbursement data.
- Prepare detailed spreadsheets and charts to analyze the flow of payments.
- Review and analyze complex medical and billing data as well as medical records.
- Prepare written investigation reports and serve subpoenas.
- Conduct surveillance and execute search warrants as needed.
- Research public records and analyze complex documents.
- Interview and coordinate with witnesses, preparing statements and affidavits.
- Communicate and consult with law enforcement, judicial personnel, and federal and state agencies.
- Testify in judicial proceedings and maintain confidentiality during investigations.
Requirements
- Bachelor's degree in accounting, finance, business administration, or criminal justice with eighteen credit hours of accounting coursework.
- Two years of experience in auditing and/or investigating tax, financial, or securities crimes.
- Intermediate knowledge of state and federal tax, financial, and/or securities laws and regulations.
- Intermediate knowledge of audit methodologies and/or forensic accounting methods.
- Ability to work independently and as part of a team.
Nice-to-haves
- Experience in forensic accounting or investigative examination processes.
- Knowledge of applicable judicial procedures and financial industry practices.
Benefits
- Paid holidays
- Health insurance
- Dental insurance
- Vision insurance
- Retirement plan
