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AUDITOR 3, MEDICAID FRAUD CONTROL UNIT (MFCU), TBI HEADQUARTERS,

ONE VACANCY

JOB DUTIES

Responsible for reviewing TennCare Program Integrity Unit (PIU) provider audit findings and referrals for accuracy and prosecution potential. Conducts audits and reviews documents including audits of nursing home cost reports, to include working directly with CPA’s at the Comptroller of the Treasury Division of State Audit.  Conducts audits of claims billed to managed care organizations (MCO’s), and determines the accuracy of MCO provider claims audits. Reviews all provider bank statements and other financial records received by MFCU Special Agents to determine the scope of healthcare fraud. Prepares investigative audit reports based on audit findings. Participates on a national team through TBI’s membership with the National Association of Medicaid Fraud Control Units (NAMFCU) on global investigations of national pharmaceutical companies for selling misbranded drugs. Assists in the preparation of quarterly and annual reports and the preparation of budget and purchasing documents.

MINIMUM QUALIFICATIONS

Education and Experience: Graduation from an accredited four-year college or university with a bachelor’s degree in accounting or a Public Accountant in good standing and experience equivalent to three years of full-time increasingly responsible professional auditing work. OR

Graduation from an accredited college or university with a bachelor’s degree including thirty-six quarter hours in accounting and experience equivalent to three years of full-time increasingly responsible professional auditing work. OR

A Certified Public Accountant with the State of Tennessee and experience equivalent to two years of full-time increasingly responsible professional auditing work.

Substitution of Education for Experience: Additional graduate coursework in business administration with a major in accounting may be substituted for the required experience, on a year-for-year basis, to a maximum of one year.

MONTHLY SALARY RANGE

$3,533 – $5,655

 For additional information please contact:

Lauren Hewgley

Human Resources Unit

Phone (615) 744-4284

Lauren.Hewgley@tn.gov

Apply for this position on requisition 154105 on the Tennessee Department of Human Resources website July 20 – July 26, 2016 at http://www.tn.gov/hr/topic/employment-opportunities.

 Positions will remain posted from July 20 – July 26, 2016, for a total of five business days.

The Tennessee Bureau of Investigation is an equal opportunity, equal access, affirmative action employer.

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