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APPROXIMATE ANNUAL SALARY -
$53,390.16 to
$78,884.64
PAY GRADE: 33
For more information on benefit and retirement programs, please see the sections below.
In order to receive consideration, applicants must indicate their availability for any work type, travel, and location requirements listed.
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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 possess a degree of knowledge and proficiency sufficient to perform work independently with little or no additional training.
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. 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***
In order to be qualified, you must meet the following requirements:
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Bachelor's degree from an accredited college or university business or public administration, business management, accounting, or related field and two years of professional experience in an investigative, auditing or professional program-related position which required the application of state and federal laws, policy and procedure in making program compliance determinations; preparing detailed reports for the purpose of justifying administrative sanctions or penalties or changes in management practices, policy and procedure; or recommending criminal prosecution; OR graduation from high school or equivalent education and four years of experience, two of which were in a professional investigative, auditing or professional program-related position which required the application of state and/or federal laws, policy and procedure in making program compliance determinations; preparing detailed reports for the purpose of justifying administrative sanctions or penalties or changes in management practices, policy and procedure; or recommending criminal prosecution; OR an equivalent combination of education and experience; OR two years of experience as a Compliance/Audit Investigator I in Nevada State service. |
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The ability to travel at least 25% of the time is required. |
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This position requires a valid driver's license or evidence of equivalent mobility at the time of appointment and for continuing employment. |
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| 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. |
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1) Describe your experience with medical terminology.
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2) Describe your experience with medical billing.
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