Medicaid Audit & Fraud Review Lead Analyst

Business and Financial Operations; Orlando (FL); On-site; USD 70,000 - 100,000; Full time

Job summary

The Audit Evaluation & Review Analyst position, part of the Medicaid Fraud Control Unit within the Office of the Attorney General, is based in Tampa or Orlando, Florida. The role conducts financial investigations and audits of Medicaid providers, including nursing facilities and hospitals, and analyzes complex financial evidence.

You will review trust accounts, calculate overpayments, and often serve as lead investigator on fraud cases involving cost reports and prospective payment systems.

Qualifications

• 6 years of professional auditing or financial analysis experience; or bachelor's degree in accounting/finance with 2+ years auditing/financial analysis experience
• Master's or advanced degree in accounting, finance, or business
• CPA or CIA license can substitute for one year of required work experience
• Knowledge of Medicaid laws, regulations, and federal/state rules
• Proficiency with financial analysis, bank statements, tax returns, and GAAP/GAAS standards
• Must pass skills verification test with minimum 70% score

Skills

Auditing/Financial analysis

Medicaid regulations

GAAP/GAAS

Skills verification test

CPA/CIA substitute

Education

Bachelor's degree in accounting/finance

Master's degree in accounting/finance/business

CPA or CIA license

Job description

The Audit Evaluation & Review Analyst position, part of the Medicaid Fraud Control Unit within the Office of the Attorney General, is based in Tampa or Orlando, Florida. The role conducts financial investigations and audits of Medicaid providers, including nursing facilities and hospitals, and analyzes complex financial evidence.

You will review trust accounts, calculate overpayments, and often serve as lead investigator on fraud cases involving cost reports and prospective payment systems.