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*
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