Texas Attorney General
OAG - Healthcare Program Enforcement | Auditor IV-V | 26-0132
Texas Attorney General, Austin, Texas, us, 78716
Join to apply for the
OAG - Healthcare Program Enforcement | Auditor IV-V | 26-0132
role at
Texas Attorney General .
General Description The Healthcare Program Enforcement Division of the Office of the Attorney General seeks an Auditor whose work involves auditing filed qui tam cases and other Medicaid fraud investigations. The role requires examining, investigating, and reviewing medical claims data, records, and reports, as well as auditing financial statements and reviewing management practices to ensure legal compliance with state statutes and internal regulations relating to medical providers participating in state health insurance programs.
The OAG is a dynamic state agency with over 4,000 employees throughout Texas. As the State’s law firm, the OAG provides exemplary legal representation in diverse areas of law. OAG employees enjoy excellent benefits (https://ers.texas.gov/Benefits-at-a-Glance) along with tremendous opportunities to do important work at a large, dynamic state agency making a positive difference in the lives of Texans.
Essential Position Functions
Performs senior‑level audits, criminal, and civil investigations and examinations of alleged Medicaid and healthcare provider fraud.
Queries, examines, and analyzes Medicaid claims data to contribute to an efficient, team‑oriented investigation; applies statistical sampling techniques as necessary; obtains information and data from various systems; and collects and analyzes case evidence, including business, financial, banking, and medical records.
Documents audits and investigations by preparing detailed audit/civil investigative reports, opening memos, and closing memos in a professional, correct, and timely manner, consistent with HPED guidelines.
Assists with outreach presentations to outside agencies, associations, or groups that can enhance HPED’s mission.
Performs related work as assigned.
Maintains relevant knowledge necessary to perform essential job functions.
Attends work regularly in compliance with the agreed‑upon work schedule.
Ensures security and confidentiality of sensitive and/or protected information.
Complies with all agency policies and procedures, including those pertaining to ethics and integrity.
Qualifications MINIMUM QUALIFICATIONS
Auditor IV
Education: Graduation from high school or equivalent.
Education: Bachelor’s degree from an accredited college or university; experience in accounting, auditing, compliance monitoring, health care insurance, law enforcement, Medicaid, or Medicare may substitute for required education on a year‑for‑year basis. CFE credential preferred.
Experience: 6 years of full‑time experience in management information systems, data science, accounting, auditing, compliance monitoring, health care insurance, law enforcement, Medicaid, or Medicare; a master’s degree may substitute for two years of required experience.
Certified Fraud Examiner (CFE).
Knowledge of word processing and electronic spreadsheet applications.
Skill in handling multiple tasks, prioritizing, and meeting deadlines.
Skill in effective oral and written communication.
Skill in exercising sound judgment and effective decision making.
Ability to supervise the work of others.
Ability to receive and respond positively to constructive feedback.
Ability to work cooperatively with others in a professional office environment.
Ability to provide excellent customer service.
Ability to work in person at the assigned OAG work location and perform all assigned tasks within that location for the entirety of each work week (unless on approved leave).
Ability to arrange for personal transportation for business‑related travel.
Ability to work more than 40 hours as needed and in compliance with the FLSA.
Ability to lift and relocate 30 lbs.
Ability to travel (including overnight travel) up to 10%.
Auditor V – All of the above qualifications for an Auditor IV, PLUS:
Experience: 2 additional years of full‑time experience in management information systems, data science, accounting, auditing, compliance monitoring, health care insurance, law enforcement, Medicaid, or Medicare; a master’s degree may substitute for two years of required experience.
TO APPLY To apply for this position, submit an electronic application through CAPPS Recruit. A State of Texas application must be completed; paper applications are not accepted. Your application may be subject to a criminal background check pursuant to the Texas Government Code. Military Crosswalk information can be accessed at https://hr.sao.texas.gov/Compensation/MilitaryCrosswalk/MOSC_AccountingAuditingandFinance.pdf.
THE OAG IS AN EQUAL OPPORTUNITY EMPLOYER
Seniority level: Mid‑Senior level. Employment type: Full‑time. Job function: Health Care Provider. Industries: Law Practice.
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OAG - Healthcare Program Enforcement | Auditor IV-V | 26-0132
role at
Texas Attorney General .
General Description The Healthcare Program Enforcement Division of the Office of the Attorney General seeks an Auditor whose work involves auditing filed qui tam cases and other Medicaid fraud investigations. The role requires examining, investigating, and reviewing medical claims data, records, and reports, as well as auditing financial statements and reviewing management practices to ensure legal compliance with state statutes and internal regulations relating to medical providers participating in state health insurance programs.
The OAG is a dynamic state agency with over 4,000 employees throughout Texas. As the State’s law firm, the OAG provides exemplary legal representation in diverse areas of law. OAG employees enjoy excellent benefits (https://ers.texas.gov/Benefits-at-a-Glance) along with tremendous opportunities to do important work at a large, dynamic state agency making a positive difference in the lives of Texans.
Essential Position Functions
Performs senior‑level audits, criminal, and civil investigations and examinations of alleged Medicaid and healthcare provider fraud.
Queries, examines, and analyzes Medicaid claims data to contribute to an efficient, team‑oriented investigation; applies statistical sampling techniques as necessary; obtains information and data from various systems; and collects and analyzes case evidence, including business, financial, banking, and medical records.
Documents audits and investigations by preparing detailed audit/civil investigative reports, opening memos, and closing memos in a professional, correct, and timely manner, consistent with HPED guidelines.
Assists with outreach presentations to outside agencies, associations, or groups that can enhance HPED’s mission.
Performs related work as assigned.
Maintains relevant knowledge necessary to perform essential job functions.
Attends work regularly in compliance with the agreed‑upon work schedule.
Ensures security and confidentiality of sensitive and/or protected information.
Complies with all agency policies and procedures, including those pertaining to ethics and integrity.
Qualifications MINIMUM QUALIFICATIONS
Auditor IV
Education: Graduation from high school or equivalent.
Education: Bachelor’s degree from an accredited college or university; experience in accounting, auditing, compliance monitoring, health care insurance, law enforcement, Medicaid, or Medicare may substitute for required education on a year‑for‑year basis. CFE credential preferred.
Experience: 6 years of full‑time experience in management information systems, data science, accounting, auditing, compliance monitoring, health care insurance, law enforcement, Medicaid, or Medicare; a master’s degree may substitute for two years of required experience.
Certified Fraud Examiner (CFE).
Knowledge of word processing and electronic spreadsheet applications.
Skill in handling multiple tasks, prioritizing, and meeting deadlines.
Skill in effective oral and written communication.
Skill in exercising sound judgment and effective decision making.
Ability to supervise the work of others.
Ability to receive and respond positively to constructive feedback.
Ability to work cooperatively with others in a professional office environment.
Ability to provide excellent customer service.
Ability to work in person at the assigned OAG work location and perform all assigned tasks within that location for the entirety of each work week (unless on approved leave).
Ability to arrange for personal transportation for business‑related travel.
Ability to work more than 40 hours as needed and in compliance with the FLSA.
Ability to lift and relocate 30 lbs.
Ability to travel (including overnight travel) up to 10%.
Auditor V – All of the above qualifications for an Auditor IV, PLUS:
Experience: 2 additional years of full‑time experience in management information systems, data science, accounting, auditing, compliance monitoring, health care insurance, law enforcement, Medicaid, or Medicare; a master’s degree may substitute for two years of required experience.
TO APPLY To apply for this position, submit an electronic application through CAPPS Recruit. A State of Texas application must be completed; paper applications are not accepted. Your application may be subject to a criminal background check pursuant to the Texas Government Code. Military Crosswalk information can be accessed at https://hr.sao.texas.gov/Compensation/MilitaryCrosswalk/MOSC_AccountingAuditingandFinance.pdf.
THE OAG IS AN EQUAL OPPORTUNITY EMPLOYER
Seniority level: Mid‑Senior level. Employment type: Full‑time. Job function: Health Care Provider. Industries: Law Practice.
#J-18808-Ljbffr