Investigative Auditor - Criminal Law Division - OAG

at Idaho Division of Human Resources in Boise, Idaho, United States

State of Idaho Opportunity

The Medicaid Fraud Control Unit ( MFCU ) is currently accepting applications for an Investigative Auditor position. The federally funded and mandated MFCU is an interdisciplinary team dedicated to protecting vulnerable individuals and safeguarding the finite resources on which they depend. This position is responsible for conducting complex criminal investigations involving Medicaid provider fraud, patient abuse, neglect, and financial exploitation. Investigations often involve multi-agency coordination, detailed evidence analysis, and preparation for prosecution.

Primary duties include:

+ Conducting interviews

+ Obtaining and analyzing Medicaid claims

+ Reviewing healthcare provider information

+ Preparing detailed investigative reports and exhibits

+ Maintaining investigative case files

+ Testifying in court

+ Interfacing with other law enforcement and government agencies

+ Travel throughout Idaho

+ Must have at least 5 years of professional auditing, financial analysis or investigative experience.

+ Above-average communication and interpersonal skills.

+ Ability to function as an integral part of an investigative team and work in a group setting.

+ Have enthusiasm for public service.

+ Strong working knowledge of Microsoft products such as Word and Excel.

+ Ability to analyze, interpret, and summarize complex financial and/or medical records.

+ Demonstrated experience in data analysis, medical auditing, or related investigative fields.

+ Must be able to drive and travel throughout Idaho.

Preferred Qualifications:

+ Bachelors degree in a field such as health information management, accounting, healthcare administration, or criminal justice.

+ Knowledge of the healthcare industry and medical coding concepts ( CPT , ICD -10, DRGs) and/or experience with healthcare claims data.

+ Experience analyzing financial records, and/or medical records.

+ Proficiency in writing affidavits, subpoenas, and investigative reports.

+ Experience testifying in court or administrative hearings.

+ Knowledge of state and federal laws and regulations related to Medicaid, healthcare fraud, and abuse.

+ Certifications such as Certified Fraud Examiner ( CFE ), Certified Professional Coder ( CPC ), Certifi