The Ohio Attorney General’s Office is currently seeking a Medicaid Fraud Analyst in the Health Care Fraud Section. The successful candidate will assist with the investigation & prosecution of criminal &/or civil Medicaid Fraud, Patient Abuse, Patient Neglect & Patient Funds cases. The duties for this position include, but are not limited to the following:
Assists with the investigation & prosecution of criminal &/or civil Medicaid fraud, patient abuse &/or neglect, & patient funds cases by reviewing & analyzing medical, financial & accounting documents to deter-mine patterns or trends that may suggest fraudulent activities: writes simple & complex queries for case data analysis; documents evidence by using computer software (e.g., Access, Excel, SQL Server) to create spreadsheets & reports; reviews, analyzes & documents information from bank records of healthcare providers; analyzes evidence & draws conclusions (e.g., determines where money is coming from, patients evaluated the most & prescriptions written; looks for cross claims & duplicate billing; evaluates data for trends & discrepancies from billing); summarizes data; runs LEADS on suspects & interviewees.
Provides technical components for undercover surveillance: Builds, in-stalls & manages covert camera/video equipment (e.g., inside nursing facilities, apartment complexes, pole cameras) for use in Medicaid fraud or patient abuse cases; works with public (e.g., patients, family members, facility management, electric company) when appropriate to install undercover surveillance; sets up covert unmanned surveillance truck (e.g., ensures local police departments & property owners aware of vehicle & surveillance as appropriate; creates forensic image of hard drive from pole & truck cameras for use as evidence; summarizes findings). Builds & manages equipment for upgrades & replacement; re-searches updated technology & equipment for potential use; provides recommendations & justification to management regarding equipment budget & purchase or building of new equipment (e.g., advises supervisor on equipment needs; performs research; analyzes equipment & describes why one is better than another; recommends building equipment if more economical than purchasing new).
Bachelor’s degree in computer programming, computer/electronic systems, accounting, or related field; valid driver’s license.
–OR Associate’s degree in computer programming, computer/electronic system, accounting or related field; 2 years experience in computer programming, computer/electronic system or accounting; valid driver’s license.
–OR 4 years of experience in computer programming, computer/electronic system &/or accounting; valid driver’s license