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DC Department of Human Resources · 21 hours ago

Financial Analyst

Washington, DC

Full-time

Onsite

Entry, Mid Level

1+ years exp

DC Department of Human Resources is seeking a Financial Analyst for the Medicaid Fraud Control Unit (MFCU) within the Office of the Inspector General. The role involves planning, coordinating, and analyzing medical claims and financial records to support criminal investigations related to healthcare fraud and abuse.

AdviceB2BEducationEmploymentHuman ResourcesManagement Consulting

No H1B

U.S. Citizen Only

Responsibilities

Independently planning, coordinating, and analyzing medical claims/healthcare billing records, and financial and business records in support of criminal investigations

Working closely with MFCU Special Agents and Federal and District prosecutors to assist in determining the appropriate evidence to be obtained through IG and/or grand jury subpoenas and, if necessary, prepares subpoenas as required

Reconstructs medical billing claims, partial or inadequate financial records of individuals, private companies, and/or governmental organizations; identifies unusual medical billing and financial pathways and associations; traces convoluted and obscure transactions and interrelationships; and analyzes and summarizes data from open source, law enforcement, District, and OIG data sources to support investigative reports and presentations

Presents financial and claims analysis results in a manner required by the special agent or prosecutor into cohesive reports and presentations in support of investigations

Documents data sources, maintains and organizes detailed records and files of assigned tasks and materials produced

Qualification

Financial analysisMedical claims evaluationCorporate financeFinancial databasesReimbursement systemsClaims processing proceduresCertified Fraud ExaminerBusiness administrationEconomicsAccountingMathematics

Required

Undergraduate and Graduate Education: Major study -- finance, business administration, economics, accounting, insurance, engineering, mathematics, banking and credit, law, or other fields related to the position

Specialized experience is experienced such as performing financial transaction analysis or medical claims evaluation work requiring a comprehensive knowledge of (1) corporate finance, financial databases, programs, and any specialized fields of finance required, such as public finance, securities, international finance, money and securities markets, investments, and banking, and (2) the financial and management structure, operations, and practices of corporate and other organizations, and (3) reimbursement systems and claims processing procedures

In addition, one year of specialized experience must be equivalent to at least the next lower grade level