Caltrans District 3 · 18 hours ago
AUDITOR I
San Diego County, CA
Full-time
Hybrid
New Grad, Entry Level
$4,256/mo - $5,600/moCaltrans District 3 is looking for an Auditor I to join their Division of Medi-Cal Fraud and Elder Abuse. The role involves conducting complex civil audits and investigations to combat healthcare fraud and protect the Medi-Cal program, utilizing analytical and quantitative skills to recover stolen funds and maintain data integrity.
Government Administration
No H1B
Security Clearance RequiredU.S. Citizen Only
Responsibilities
Conducts complex civil audits and investigations for the Civil Section, including:
Work with auditors and attorneys from other state Medicaid Fraud Control Units and/or Federal Assistant United States Attorneys to combat global health fraud. Review and provide claims data of suspected activity and assist in civil remediation
Obtains and analyzes information from Medi-Cal claims database(s) and other evidence obtained from a variety of sources associated with cases and complaints of alleged Medi-Cal provider fraud
Identifies, gathers, and maintains voluminous data relevant to such allegations
Estimating and calculating monetary losses to the Medi-Cal program, including determining the reasonableness of audit findings and evaluating such results through comparative analysis and independent third-party verification
Conducting interviews, performing any and all fieldwork needed for the audit or investigation, compiling and evaluating competent evidentiary material, developing audit findings, preparing detailed reports of investigation and schedules of findings that result from investigative activities and records examinations
Participating in meetings, depositions, and interviews with qui tam relators, investigative, legal, and managerial staff, as well as private law firms and various governmental agencies
Developing forensic investigative strategies and identifying resources necessary to perform various audit and investigative assignments
Collaborating with teams of attorneys, paralegals, support staff, investigators, agents and auditors, and other analysts both within and beyond the Division
Utilizing computerized audit techniques with tools including MIS/DSS claims database, Business Objects, Medi-Cal Management Information System, Lexis-Nexis, Microsoft Office Suite, SAS Enterprise Guide to develop programs and other information for sampling, cost evaluations, determining patterns, and trend analysis
Assisting in the preparation (including drafting) and service of subpoenas, as well as in the preparation of discovery requests and discovery responses
Assisting in the preparation of matters set for hearing, settlement, and trial, including testifying in civil hearings, depositions, and trials both in person and by affidavit
Qualification
Required
Experience and knowledge working with Medical Claims
Experience in conducting complex financial and forensic audits and investigations, researching and interpreting complex rules and regulations, reviewing and analyzing accounting records and financial institution records, performing statistical analyses for large volumes of data, and testifying in court or administrative hearings
Proficiency in generating work products and/or spreadsheets using Excel
Ability to write and produce concise, professional documents and reports, and to express facts and conclusions precisely and clearly
Successful completion of college-level courses in elementary and intermediate accounting, auditing, and cost accounting, as well as statistics
Ability to work under limited supervision on multiple assignments within a team environment
Proactive in the identification and successful resolution of issues
Regularly exercise the highest degree of professional judgment, integrity, and maturity
A fingerprint check will be required
Complete and pass Penal Code 832, arrests, search, and seizure training during the probationary period
Clearly indicate the JC-504219 of JC-504230 and the title of this position in the 'Examination or Job Title(s) For Which You Are Applying' section located on the first page of your State Application
Clearly indicate the basis of your eligibility in the 'Explanations' section located on the first page of your State Application
If you are using education to meet the minimum qualifications for this position, you must submit a copy of your unofficial transcripts. Unofficial school transcripts may be accepted during the application process; however, submission of official transcripts or your diploma is required prior to appointment
Current version of the State Examination/Employment Application STD Form 678 (when not applying electronically), or the Electronic State Employment Application through your Applicant Account at www.CalCareers.ca.gov. All Experience and Education relating to the Minimum Qualifications listed on the Classification Specification should be included to demonstrate how you meet the Minimum Qualifications for the position
Resume is required and must be included
Statement of Qualifications - A Statement of Qualifications (SOQ) is required. The SOQ prompt is listed below. Applicants who do not submit an SOQ will not be considered for this position. Please note that resumes, letters, transcripts, degrees, your state application, cover letters, and other materials will not take the place of the SOQ
Preferred
Ability to work flexible, possibly extended hours, and to travel, as needed
Experience working NAMFCU cases and prior experience working as a Global Case team member
Proficiency using and SAS Enterprise Guide
Benefits
Please access this link for information on benefits afforded to employees who work for the State of California - https://www.calhr.ca.gov/Pages/California-State-Civil-Service-Employee-Benefits-Summary.aspx
Company
Caltrans District 3
Caltrans District 3 is a government administration company based out of 703 B ST, Marysville, California, United States.
Founded in 1895Marysville, California, US
1001-5000 employees
Funding
Current Stage
Late StageCompany data provided by crunchbase