Litigation and Investigations Auditor

The Opportunity:

Join our team as a Litigation and Investigations Auditor to support the United States Attorneys Office (USAO)

In this role you will work under the direction of Assistant United States Attorneys (AUSAs) to assist in the investigation and trial preparation phases. Your responsibilities will include conducting medical claims data analysis forensic investigations financial damages assessments statistical sampling and ability-to-pay analyses. These tasks are crucial for determining the outcomes of investigations prosecutions settlements and recoveries.

Confidentiality is paramount in this role. You will handle individually identifiable medical information matters under seal (such as qui tam lawsuits) and grand jury proceedings with the utmost discretion. Your work may involve sensitive matters and prominent individuals organizations or corporations within a U.S. Attorneys district all of which must be kept confidential.

Responsibilities:

• Conduct audits in support of investigations and litigation involving the governments affirmative civil enforcement of federal laws including the False Claims Act Anti-Kickback Statute and Stark Law.

• Perform audits in support of criminal investigations involving various U.S. Code sections related to fraud and money laundering.

• Review analyze and interpret complex data sets including CMS claims data PPP loan data and records associated with healthcare and defense procurement fraud.

• Identify outlier billings and anomalies within healthcare claim codes and normalize claims data across multiple benefit plans.

• Detect trends patterns and relevant information within investigative and discovery records and apply this analysis to test data under various conditions.

• Reinterpret and extrapolate results from Statistically Valid Random Samples when modifications to sample review outcomes occur.

• Develop document and defend loss calculation methodologies and financial damage models for litigation.

• Conduct financial investigations to assess the ability of individuals and organizations to satisfy settlements and judgments including detailed analysis of assets liabilities and financial records.

• Examine personal and business financial records to identify payments kickbacks money flows and related-party transactions.

Qualifications:

Required:

• CPA certification.

• MBA or equivalent in accounting or a directly related field.

• Thorough knowledge of generally accepted accounting principles (GAAP) and generally accepted auditing standards (GAAS).

• Minimum of three years experience as an auditor.

• Minimum of two years specialized experience in subject matter areas such as Medicare billing and claims systems or DoD inventory systems.

• Working knowledge of appropriate accounting and financial analysis ADP systems and applications.

• Excellent oral and written communication skills.

Desired:

• Exceptional attention to detail.

• Prior experience as part of an auditing team.

• Experience in a litigation environment with experience working with automated litigation support tools being helpful.