Compliance/Audit Investigator 1-Underfill

State of Nevada•Carson City, NV

12h•Onsite

About The Position

The Department of Business and Industry is recruiting to underfill a Compliance Audit Investigator 2 position within the Workers' Compensation Section of the Division of Industrial Relations in Carson City. The incumbent will conduct compliance audits of insurer and third-party administrator workers' compensation claim files, verify compensation calculations, conduct complaint investigations, write comprehensive audit reports and determinations, and assess administrative fines pursuant to NRS and NAC 616A through D and 617, and in accordance with Division guidelines; conduct employer site visits; interview injured employees and employer personnel; testify during administrative and/or criminal hearings when necessary; provide employer outreach or training, which requires public speaking. This is the entry level class which provides for progression to the next level upon meeting the minimum qualifications, satisfactory performance and with the recommendation of the appointing authority. Under close supervision, incumbents receive on-the-job and/or formal training in the areas of compliance investigation and auditing. Incumbents also receive training in the laws, regulations, policies and procedures associated with the assigned program area. Incumbents perform all duties described in the series concept.

Requirements

Bachelor's degree from an accredited college or university in business or public administration, business management, accounting, or related field; OR graduation from high school or equivalent education and two years of experience in an auditing or program-related position equivalent to an Administrative Assistant III or Accounting Assistant III in Nevada State service which required the application of federal and/or State laws, policy and procedures; reviewing documents prepared by others for program compliance determinations; preparing reports which summarize financial and statistical information; or maintaining financial records related to revenues and expenses, grants, budgets, purchases, and/or accounts; OR an equivalent combination of education and experience as described above.
General knowledge of research techniques and application.
General knowledge of basic investigative and auditing techniques.
Ability to write concise, logical and grammatically correct reports.
Ability to speak on a one-to-one basis using appropriate vocabulary and grammar to obtain information and to explain policies.
Ability to record information quickly and accurately.
Ability to convey accurate and precise data in a timely manner within established time frames.
Ability to read and interpret statutes related to the program area to determine compliance.
Ability to speak with individuals of various social, cultural, economic and educational backgrounds.
Ability to maintain cooperative working relationships with staff members.
Ability to work independently and as part of a team.
Ability to complete required forms and documents.

Responsibilities

Conduct compliance audits of insurer and third-party administrator workers' compensation claim files.
Verify compensation calculations.
Conduct complaint investigations.
Write comprehensive audit reports and determinations.
Assess administrative fines pursuant to NRS and NAC 616A through D and 617, and in accordance with Division guidelines.
Conduct employer site visits.
Interview injured employees and employer personnel.
Testify during administrative and/or criminal hearings when necessary.
Provide employer outreach or training, which requires public speaking.
Receive and review formal complaints.
Make determinations regarding possible program violations and jurisdiction within the specified program area.
Gather and analyze background information and facts pertaining to the complaint.
Make determinations regarding the extent of violations, and recommendations to initiate a formal investigation.
Conduct interviews with complainant, witnesses, employers, State and local government agencies and other sources to obtain information regarding violations or noncompliance and develop leads and facts pertaining to the case to prove a violation or criminal intent exists.
Prepare required forms and notices.
Deliver to appropriate party regarding complaint and/or alleged violations following department policy and procedure.
Respond, review and discuss with complainant and respondent.
Develop case files and maintain case logs and reports.
Place evidence in case file along with chronological documentation regarding investigative steps taken and all contact made with complainant, respondent, witnesses and other sources.
Preserve and utilize evidence to develop final case reports and/or for future litigation.
Gather and review evidence such as business and financial records, service contracts, professional reports, bank statements, billing documents, sales transactions, client account records, personnel files and historical data pertaining to the suspected violation to develop trends, patterns and to support complaint.
Serve subpoenas or other legal documents as required.
Conduct audits on a periodic basis by either randomly selecting individual firms or business or as required by State law and reviewing business transactions for completeness, accuracy, and compliance with federal and/or State laws and regulations.
Evaluate internal procedures, operating methods, fiscal controls, and verify validity of financial statements and records.
Explain provisions and application of federal and/or State guidelines and discuss assessments, audit findings and recommendations.
Prepare required forms and notices and send to appropriate parties regarding complaint and alleged violations.
Review and discuss responses with supervisor and/or Attorney General.
Conduct research regarding program rules, court decisions, industry practices and standards, procedures and techniques to ensure compliance, and to develop or revise program regulations or policies.
Plan and coordinate investigations and audits to determine whether administrative and/or criminal action should be taken.
Prepare investigative and audit reports encompassing results of examination of accounting records, known violations, statement of facts, case summary, and exhibits of evidence, statements obtained from witnesses, conclusions and recommendations.
Review and submit reports for hearing or prosecution, and to impose fines and penalties.
Appear before the governing body or in a court of law to provide testimony as required.
Perform related duties as assigned.