What are the responsibilities and job description for the Accountant/Auditor 4 - Human Services - Bureau for Medical Services - Kanawha Co. position at West Virginia?
JOB
Department of Human Services (DOHS)/ Bureau for Medical Services (BMS)/ Kanawha Co - Under limited supervision of the Bureau for Medical Services, performs expert level accounting, auditing, and reporting functions specific to the Bureau’s Office of Program Integrity’s Financial Audit Program. This position is the liaison with the WV state staff during non-Bureau State audits of the Bureau for Medical Services Medicaid program integrity and manages the creation and implementation of any necessary corrective action plan and assists federal, state, and local law enforcement agencies conducting specialized fraud investigations by referring suspected fraud to the Office of the WV Attorney General Medicaid Fraud Control Unit and conducts unannounced on-site audits of provider records and facilities. Conducts audits of Medicaid services and processes, provider fraud, special compliance reviews with internal control evaluations and recommendations, and investigates sensitive agency and vendor activities which include, but are not limited to, high value/complexity audits of claim, encounter, capitation, revenue code, and administrative payments made by the Bureau. Analyzes complex administrative and technical issues to prevent fraud, waste, and abuse to the Bureau by applying forensic accounting principles and formulates suggested improvements to resolve problems; evaluates and approves selection of information to be included in findings reports and provider letters. Writes comprehensive review programs, audits claim payments and related financial records, develops sampling and other techniques of evaluation, prepares reports of auditors’ findings, recommendations, and conclusions; assists in explaining findings and recommendations to agency leadership and partners; develops, implements, and maintains audit schedules. Performs highly specialized and complex analysis, auditing, and reporting functions, requiring extensive experience with the Bureau’s programs, policies, data, and related State and Federal regulations ensuring compliance with reporting rules and deadlines. Reports development and use of independent judgement in interpretation of pertinent policies, rules, and regulations. Acts as agency contact to maintain, track, and manage requests from external auditors. Evaluates operational procedures to recommend improvements to achieve maximum efficiency and effectiveness. Performs other related work as required.Click The APPLY Link To Apply Online. IMPORTANT: Your eligibility will be based on information provided in your resume or application; therefore, make sure your resume or application is detailed and complete. You MUST complete ALL parts of the application OR upload a resume to your submission.ATTENTION: Applicant must verify post high school education by submitting an official transcript or diploma, training or licensure earned pertaining to this position by the closing date of the posting, if not previously verified. If you are claiming Veterans preference, please submit "MEMBER 4" of your form DD214 and/or your VA Letter. Protecting your personal information is our highest priority. If your official transcript, training/licensure, or Veterans documentation contains your Social Security Number and/or birthdate, please redact that information before submitting it to the Division of Personnel. Please attach documents to the online application before submitting it. Or, you may email it to: applicantservices@wv.gov or by mail to: WV Division of Personnel, 1900 Kanawha Blvd. E., Building 3, Suite 500, Charleston, WV 25305.Be sure to submit your resume or application for each position of interest. To receive an email notice anytime jobs in this or other categories are posted, you may choose to complete a Job Interest Card from the slide-out menu located at the top left of our Job Opportunities page.
SUPPLEMENTAL INFORMATION
Substitution: An additional one (1) year of experience in accounting, auditing, bookkeeping, and/or finance may substitute for the required accounting semester hours at the rate of one (1) year of experience for every thirty semester hours.
Department of Human Services (DOHS)/ Bureau for Medical Services (BMS)/ Kanawha Co - Under limited supervision of the Bureau for Medical Services, performs expert level accounting, auditing, and reporting functions specific to the Bureau’s Office of Program Integrity’s Financial Audit Program. This position is the liaison with the WV state staff during non-Bureau State audits of the Bureau for Medical Services Medicaid program integrity and manages the creation and implementation of any necessary corrective action plan and assists federal, state, and local law enforcement agencies conducting specialized fraud investigations by referring suspected fraud to the Office of the WV Attorney General Medicaid Fraud Control Unit and conducts unannounced on-site audits of provider records and facilities. Conducts audits of Medicaid services and processes, provider fraud, special compliance reviews with internal control evaluations and recommendations, and investigates sensitive agency and vendor activities which include, but are not limited to, high value/complexity audits of claim, encounter, capitation, revenue code, and administrative payments made by the Bureau. Analyzes complex administrative and technical issues to prevent fraud, waste, and abuse to the Bureau by applying forensic accounting principles and formulates suggested improvements to resolve problems; evaluates and approves selection of information to be included in findings reports and provider letters. Writes comprehensive review programs, audits claim payments and related financial records, develops sampling and other techniques of evaluation, prepares reports of auditors’ findings, recommendations, and conclusions; assists in explaining findings and recommendations to agency leadership and partners; develops, implements, and maintains audit schedules. Performs highly specialized and complex analysis, auditing, and reporting functions, requiring extensive experience with the Bureau’s programs, policies, data, and related State and Federal regulations ensuring compliance with reporting rules and deadlines. Reports development and use of independent judgement in interpretation of pertinent policies, rules, and regulations. Acts as agency contact to maintain, track, and manage requests from external auditors. Evaluates operational procedures to recommend improvements to achieve maximum efficiency and effectiveness. Performs other related work as required.Click The APPLY Link To Apply Online. IMPORTANT: Your eligibility will be based on information provided in your resume or application; therefore, make sure your resume or application is detailed and complete. You MUST complete ALL parts of the application OR upload a resume to your submission.ATTENTION: Applicant must verify post high school education by submitting an official transcript or diploma, training or licensure earned pertaining to this position by the closing date of the posting, if not previously verified. If you are claiming Veterans preference, please submit "MEMBER 4" of your form DD214 and/or your VA Letter. Protecting your personal information is our highest priority. If your official transcript, training/licensure, or Veterans documentation contains your Social Security Number and/or birthdate, please redact that information before submitting it to the Division of Personnel. Please attach documents to the online application before submitting it. Or, you may email it to: applicantservices@wv.gov or by mail to: WV Division of Personnel, 1900 Kanawha Blvd. E., Building 3, Suite 500, Charleston, WV 25305.Be sure to submit your resume or application for each position of interest. To receive an email notice anytime jobs in this or other categories are posted, you may choose to complete a Job Interest Card from the slide-out menu located at the top left of our Job Opportunities page.
SUPPLEMENTAL INFORMATION
Substitution: An additional one (1) year of experience in accounting, auditing, bookkeeping, and/or finance may substitute for the required accounting semester hours at the rate of one (1) year of experience for every thirty semester hours.
