Financial Investigator

State of North Carolina

About The Position

The North Carolina Department of Justice, led by the Attorney General of North Carolina, represents the state, state agencies, and elected officials, and defends the rights of the people of North Carolina. The Department handles all state criminal appeals cases and assists district attorneys with complex criminal cases at their request. Additionally, the Department of Justice includes the North Carolina State Crime Lab, the North Carolina Justice Academy, and the Sheriffs’ and Criminal Justice Education and Training Standards Divisions. The primary purpose of this position is to perform investigations in the area of criminal and civil Medicaid fraud schemes, patient abuse or neglect, and misappropriation of recipient funds by conducting and participating in wide variety of case investigations involving financial analysis. Work requires knowledge of applicable state and Federal laws and regulations. The Medicaid Investigations Division (MID) investigates and prosecutes health care fraud committed by Medicaid providers and the physical abuse of patients and embezzlement of patient funds in Medicaid-funded facilities. MID works closely with district attorneys’ offices, US Attorneys’ offices, federal, state and local agencies across the State. The damages in a Medicaid fraud case can range from a few thousand dollars to tens of millions of dollars. MID’s enforcement actions protect and recover taxpayer funds and help ensure access to needed medical services for Medicaid enrollees. The State of North Carolina offers employer paid health insurance plus twelve paid holidays, generous vacation and sick leave accrual, dental, vision, and other insurance options, and retirement benefits. You can view our benefits information at Employee Benefits. North Carolina State Government is one of the state’s largest employers, with over 76,000 employees all working toward a common goal: a safer and stronger North Carolina. We are a large organization comprised of various agencies, offices, and universities, each providing important public services. Eligible state employees are entitled to comprehensive benefits, including a variety of leave options, professional development opportunities, insurance, and more. To learn more about the benefits of being a North Carolina state employee, visit the N.C. Office of State Human Resources' website.

Requirements

Bachelor’s degree in accounting, finance, business administration or criminal justice from an appropriately accredited institution, with eighteen credit hours of accounting coursework and two years of experience in auditing and/or investigating tax, financial, or securities crimes; or equivalent combination of education and experience.
May require certification as a Law Enforcement Officer or Special Agent in accordance with the provisions of the North Carolina Criminal Justice Training and Standards Commission or the ability to achieve certification within one year of employment.
Ability to maintain confidentiality & discretion while conducting criminal & civil investigations.
Ability to clearly communicate verbal & written information in a clear & concise manner.
Advanced skills involving Microsoft Office Products, especially Excel.

Nice To Haves

Law enforcement background.

Responsibilities

Conducting complex criminal and civil investigations involving Medicaid provider fraud and patient abuse and neglect.
Data analysis of Medicaid claims.
Reviewing financial documents, including bank statements, cancelled checks, corporate and individual income tax returns, etc.
Reviewing medical records and service notes of Medicaid Recipients.
Interviewing witnesses, including Medicaid Recipients, current and former employees, Medicaid Policy administrators, DHHS employees, DSS employees, etc.
Interviewing individuals suspected of committing Medicaid provider fraud and patient abuse and neglect.
Preparing detailed reports from the results of interviews conducted.
Working with Federal, State and local law enforcement agencies, including AUSAs.
Testifying in State and/or Federal court.
Understanding of the Rules of Evidence in criminal investigations.