COMPLIANCE/AUDIT INVESTIGATOR 1

Announcement Number: 48765 Open to all qualified persons. Posted 09/09/2024 Close Date: 09/23/2024 Recruiter:
MELISSA PONTILLO
Email: mpontillo@admin.nv.gov Applications accepted for another 7 Days 18 Hrs 50 Mins
The Position

Compliance/Audit Investigators perform investigative and auditing functions to monitor compliance and detect violations of federal and/or State laws or regulations pertaining to a specific program or regulatory area such as securities, Medicaid, mortgage lending, or workers' compensation. Investigators allocated to this series do not require P.O.S.T. certification.

Incumbents perform in a trainee capacity and acquire the knowledge, skills and abilities required in this occupation.

This position is located in the Las Vegas office and serves as a Compliance Audit Investigator II in the Workers' Compensation Section, Medical Unit. This position requires the incumbent to respond to complaints, medical billing appeals, late and/or incomplete C-4 Forms, and conducts investigations/audits with various stakeholders within the workers' compensation community, primarily focused on issues concerning health care providers. Acts to ensure compliance with relevant NRS, NAC, Medical Fee Schedule and other adopted guidelines. May assist with maintenance of provider panels as assigned. Resolves issues, when possible, may issue administrative fines when appropriate. Position utilizes advanced business writing skills in report writing, including proper grammar, sentence structure and vocabulary as this position writes determination letters and other business correspondence. Assists with other projects as assigned. The State of Nevada is an equal opportunity employer dedicated to building diverse, inclusive, and innovative work environments with employees who reflect our communities and enthusiastically serve them. All applicants are considered without regard to race, color, national origin, religion or belief, age, disability, sex, sexual orientation, gender identity or expression, pregnancy, domestic partnership, genetic information (GINA), or compensation and/or wages. ***THIS RECRUITMENT MAY CLOSE WITHOUT FURTHER NOTICE DEPENDING ON THE NUMBER OF APPLICATIONS RECEIVED. APPLICANTS ARE ENCOURAGED TO APPLY AS SOON AS POSSIBLE***

To see full Class Specifications visit: http://hr.nv.gov/Resources/ClassSpecs/Class_Specifications-11_0/

To Qualify:

In order to be qualified, you must meet the following requirements:
Education and Experience (Minimum Qualifications) 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 state and/or federal 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. Special Notes Moderate travel is required. Special Requirements A valid driver's license or evidence of equivalent mobility is required at the time of appointment and as a condition of continued employment. The Examination Application Evaluation Exam The exam will consist of an application evaluation. It is essential that applications include detailed information with time frames regarding education and experience. The most qualified applicants will be contacted by the hiring agency for interview. The hiring agency may require specific skills related testing as part of the interviewing process.
The following additional questions are part of this Recruitment

1) Describe your experience with medical billing.
INFORMATIONAL LINKS For more information about state employment, visit the following:
Division of Human Resource Management: http://hr.nv.gov
Public Employees Retirement System: http://www.nvpers.org
Public Employees Benefits Program: http://pebp.state.nv.us
More Benefits Information: http://nvjobs.nv.gov/Applicants/EB
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Email Direct Inquiries or Correspondence to: Division of Human Resource Management
Northern Nevada
515 East Musser Street,
First Floor
Carson City, Nevada 89701-4204

Indian Springs, Nevada United States View Map