Enfermeiro Auditor Supervisor overseeing audit processes and clinical conditions in healthcare management. Collaborating with external teams and clients for operational improvements and quality assurance.
About the role
- Auditor providing auditing and accounting services in support of fraud investigations at CGS. Developing technical guidelines and analyzing complex financial transactions.
Responsibilities
- Provide general auditing and accounting services in support of fraud investigations involving potentially complex financial transactions
- Develop, coordinate, and draft technical audit guidelines
- Analyze and audit a variety of accounting systems
- Analyze, organize, and present a large volume of data such as bank records, financial records, healthcare claims, tax records, correspondence, policies, other documentary evidence, etc., through the use of common software programs
- Assist with the planning of investigations, including performing quantitative and qualitative analyses to identify potential witnesses and relevant financial documents
- Prepare concise and accurate reports of results of analysis, including detailed charts, summaries and schedules as necessary
- Assist with conferences and interviews of representatives of financial institutions, Certified Public Accountants, and other potential witnesses to financial activities
- Utilize electronic databases to identify assets, documents, and other physical evidence
- Analyze an individual or corporation’s ability to pay monetary penalties based on financial disclosures and independent investigation of assets and liabilities
- Perform ancillary investigation-related services in support of assigned cases as follows: Develop, coordinate and issue draft technical audit guidelines and instructions applicable to financial audits and investigations
- Prepare interim and final reports throughout the investigation process for use by staff members
- Arrange for secure storage, preservation, organization and indexing of voluminous documentary evidence
- Assist in the compilation and analysis of documents and physical evidence, and the creation of charts, graphs, and other audio-visual materials for use in motions and at trial
- Meet with the designated federal agency personnel, state and local officials as needed throughout investigations
- Other related duties as assigned and within scope.
Requirements
- Four-year undergraduate degree or higher in statistical/data analysis, finance, accounting, fraud examination, or other related field.
- Minimum 3 years of professional work experience in finance, accounting, fraud examination or statistical/data analysis.
- Proficient in Microsoft Office applications including Word, Excel, PowerPoint, Access, etc.
- U.S. Citizenship and ability to obtain adjudication for the requisite background investigation.
- Experience and expertise in performing the requisite services in Section 3 Preferred qualifications:
- Experience reviewing and understanding medical records and knowledge of medical billing procedures, including experience using STARS and/or Business Objects.
- Relevant experience working with a federal or state legal or law enforcement entity.
Benefits
- Health, Dental, and Vision
- Life Insurance
- 401k
- Flexible Spending Account (Health, Dependent Care, and Commuter)
- Paid Time Off and Observance of State/Federal Holidays
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