Requisition No: 798827
Agency: Office of the Attorney General
Working Title: AUDIT EVALUATION & REVIEW ANALYST (ORL or TPA)
Position Number: 41000696
Salary: $50,000 – $60,000
Posting Closing Date: 04/29/2023
* This position may be filled in Orlando or Tampa *
Our Organization and Mission:The Office represents the State of Florida in state and federal civil and criminal courts, from trial courts to the Supreme Court of the United States.
Pay: $50,000 – $60,000 Annually
Position Summary: This position is in the Medicaid Fraud Control Unit and involves auditing complex multi-million-dollar healthcare fraud investigations that can result in criminal and/or civil litigation. This position’s primary duties require advanced knowledge and educational requirements of a bachelor’s degree with a major in accounting and five years of professional auditing or financial analysis experience. The ability to exercise discretion and judgment when applying the rules, regulations, and laws of the Medicaid unit, both Federal and State.
Qualifications: A bachelor’s degree from an accredited college or university with a major in accounting or finance and at least three years of professional auditing or financial analysis experience; or a master’s or other advanced degree from an accredited college or university in accounting or business or possession of a Certified Public Accountant (C.P.A.) or Certified Internal Auditor (C.I.A.) certificate can substitute for one year of the required experience.
** SKILLS VERIFICATION TEST ** All applicants who meet the screening criteria/minimum job requirements will be required to take a timed Skills Verification Test. Applicants must receive a score of at least 70% to move to the interview phase.
The Work You Will Do:The incumbent will be responsible for, but not limited to the following:
- Requires the use of professional judgment and experience regarding Medicaid Laws and Regulations and the ability to provide financial expertise to the investigative team by:
- Reviewing resident trust accounts,
- Guiding and directing Medicaid Analysts as needed
- Conducting random sampling in accordance with HHS-OIG standards,
- Calculating Medicaid overpayments and exploitation losses,
- Providing financial interpretation and guidance as required by the Assistant Attorney General, Lead Investigator, and Medical Investigator.
- Serve as lead investigator on cases involving suspected Cost Report Fraud:
- Nursing Homes, Hospitals, and Intermediate Care Facilities for Individuals with Intellectually Disabilities (ICF/IID). In this capacity, an Auditor gathers or assists in gathering financial evidence; performs audits, examinations, and reviews of financial evidence gathered in accordance with the Agency’s and the Medicaid Fraud Control Unit’s (MFCU) standard operating procedures, the U.S. Generally Accepted Accounting Principles (GAAP), the U.S. Generally Accepted Auditing Standards (GAAS), and other applicable financial standards/procedures governed by authoritative bodies and organizations such as the Financial Accounting Standards Board (FASB), the Auditing Standards Board (ASB), the Accounting and Review Services Committee (ARSC), the Securities and Exchange Commission (SEC), the American Institute of Certified Public Accountants (AICPA).
- Auditing and analyzing complex financials of the managed care provider including their provider network. Analyze and interpret managed care encounter data. Communicating the results of your analysis clearly and concisely, in both written and verbal forms to internal personnel and case database as well as outside parties.
- Provide complex analysis (including link analysis) and interpretation of:
- Bank and credit card statements,
- IRS tax returns, both corporate and individual,
- Target assets subject to seizure,
- Financial records, including general ledger, trial balance, income statement, balance sheet, and statement of cash flow.
- Perform other related duties as assigned.
The Benefits of Working for the State of Florida:Working for the State of Florida is more than a paycheck. The State’s total compensation package for employees features a highly competitive set of employee benefits including:
- Annual and Sick Leave benefits.
- Nine paid holidays and one personal holiday each year.
- State Group Insurance coverage options, including health, life, dental, vision, and other supplemental insurance option.
- Retirement plan options, including employer contributions (For more information, please click www.myfrs.com).
- Flexible Spending Accounts
- Tuition waivers.
- And more! For a more complete list of benefits, visit www.mybenefits.myflorida.com.
IMPORTANT NOTICE: To be considered for the position, all applicants must:
Submit a complete and accurate application profile necessary for qualifying such as dates of service, reason for leaving, etc. In addition, all applicants must ensure all employment and/or detailed information about work experience is listed on the application (including military service, self-employment, job-related volunteer work, internships, etc.) and that gaps in employment are explained. NOTE: Any required experience and/or preferences listed in the advertisement must be verified at the time of application.
- Ensure that applicant responses to qualifying questions are verifiable by skills and/or experience stated on the employment application and/or resume. Applicants who do not respond to the qualifying questions will not be considered for this position.
- The elements of the selection process may include a skill assessment exercise.
- Current and future vacancies may be filled from this advertisement for a period of up to six months. Following the six-month period, a new application must be submitted to an open advertisement to be considered for that vacancy.
- OAG employees are paid biweekly. All state employees are required to participate in the direct deposit program pursuant to s. 110.113, FS.
CRIMINAL BACKGROUND CHECKS/ DRUG FREE WORKPLACE:All OAG positions are “sensitive or special trust” and require favorable results on a background investigation including fingerprinting, pursuant to s. 110.1127(2)(a), F.S. The State of Florida supports a Drug-Free Workplace, all employees are subject to reasonable suspicion or other drug testing in accordance with section 112.0455, F.S., Drug-Free Workplace Act. We hire only U.S. citizens and those lawfully authorized to work in the U.S.
E-VERIFY STATEMENT:The Office of the Attorney General participates in the U.S. government’s employment eligibility verification program (e-verify). E-verify is a program that electronically confirms an employee’s eligibility to work in the United States after completion of the employment eligibility verification form (i-9).
REMINDERS:Male applicants born on or after October 1, 1962, will not be eligible for hire or promotion unless they are registered with the Selective Service System (SSS) before their 26th birthday, or have a Letter of Registration Exemption from SSS. For more information, please visit the SSS website at: https: //www.sss.gov. If you are a retiree of the Florida Retirement System (FRS), please check with the FRS on how your current benefits will be affected if you are re-employed with the State of Florida. Your current retirement benefits may be canceled, suspended, or deemed ineligible depending upon the date of your retirement.
The State of Florida is an Equal Opportunity Employer/Affirmative Action Employer, and does not tolerate discrimination or violence in the workplace.
Candidates requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and/or People First Service Center (1-866-663-4735). Notification to the hiring authority must be made in advance to allow sufficient time to provide the accommodation.
The State of Florida supports a Drug-Free workplace. All employees are subject to reasonable suspicion drug testing in accordance with Section 112.0455, F.S., Drug-Free Workplace Act.
VETERANS’ PREFERENCE. Pursuant to Chapter 295, Florida Statutes, candidates eligible for Veterans’ Preference will receive preference in employment for Career Service vacancies and are encouraged to apply. Certain service members may be eligible to receive waivers for postsecondary educational requirements. Candidates claiming Veterans’ Preference must attach supporting documentation with each submission that includes character of service (for example, DD Form 214 Member Copy #4) along with any other documentation as required by Rule 55A-7, Florida Administrative Code. Veterans’ Preference documentation requirements are available by clicking here. All documentation is due by the close of the vacancy announcement.