Forensic Auditor: Support Healthcare Fraud Investigations (6313)

Minimum Qualifications Qualifications :

• A minimum of a four-year college degree, either specifically in accounting, finance, economics, computer science with data analysis, applied statistics or equivalent post-college work experience.
• Excellent analytical, communication, and organizational skills.
• The ability to function as an integral part of an investigative team and work in a group setting.
• Knowledge of fundamental computer applications, such as Word, Excel, and Access.
• Proficiency with presentation software, such as PowerPoint.

Preferred skills :

• The ability to review financial records and advise or assist in the investigation of alleged fraud.
• Designation as a Certified Fraud Examiner.
• Experience with statistical sampling and / or advanced statistical training.
• Knowledge of the healthcare industry and medical coding concepts (CPT, ICD-9 / 10, DRGs) and / or experience analyzing health care claims data.
• A CPA is not required, but the position qualifies for CPA accreditation purposes.

Duties Description Division of Criminal Justice

Medicaid Fraud Control Unit Hauppauge (Suffolk County)

Forensic Accountant / Auditor

Reference No. MFCU FAA HAU 6313

Application Deadline is April 5, 2024

Entry-Level Opportunity for College Graduates

The Office of the New York State Attorney General’s (OAG) Medicaid Fraud Control Unit (MFCU) seeks a forensic accountant / auditor (FAA) for its Long Island office in Hauppauge.

The FAA supports the Unit by working in partnership with its attorneys, detectives, data analysts, nurses, and legal support analysts to conduct complex, long-term healthcare fraud investigations.

The Medicaid program provides health coverage to millions of New Yorkers, including low-income persons, children, elderly adults, and people with developmental disabilities.

MFCU is the nation’s premier law enforcement agency charged with ensuring the financial integrity of New York State’s $100 billion Medicaid program by investigating healthcare providers, such as pharmaceutical companies, doctors, hospitals, and nursing homes, who engage in Medicaid billing schemes that cause harm to Medicaid recipients and the loss of millions of dollars to the State of New York.

MFCU also works to protect elderly and disabled New Yorkers by investigating reports of abuse and neglect in nursing homes and other residential health care facilities in the state.

Possessing both civil and criminal enforcement powers, MFCU uses various state laws to bring civil actions and criminal proceedings, including asset forfeiture actions.

Many of the Unit’s investigations are conducted in coordination with other federal, state, or local government and prosecutorial agencies, and have resulted in large-scale criminal convictions and the recovery of millions of dollars of taxpayer money.

Several recent matters that highlight MFCU’s important work include the OAG’s report concerning neglect of nursing home residents across New York State during the COVID-19 pandemic, and the recent filing of four major lawsuits against nursing homes, including Centers Health Care, Cold Spring Hills Center for Nursing and Rehabilitation, The Villages of Orleans Health and Rehabilitation Center, and Fulton Commons Care Center, Inc.

Additional recent significant cases include the indictment of a Long Island physician for defrauding Medicaid and subjecting patients to invasive and unnecessary testing, conviction of former fugitive dentist for Medicaid Fraud and prosecution and convictions of persons involved in a homicide and cover up at a nursing home in Suffolk County.