State of Washington Classified Job Specification
ORGANIZATIONAL & FISCAL AUDITOR 3
Class Series Concept
This series is used within the Department of Social & Health Services. Positions are located in the Office of Nursing Home Audits and the Office of Operations Review. Positions conduct both fiscal and program audits of nursing homes and Medicaid programs in hospitals. Other positions are located in the Office of the Attorney General's Criminal Division or the Medical Fraud Control Unit conducting audits related to the detection, prevention, and prosecution of economic and financial crimes involving Medicaid funded programs.
This is the senior, specialist, or leadworker level of the series. Most positions at this level have lead work responsibility. Employees in these positions plan the assigned audits and prepare reports of audit findings and recommendations. Audit activities in these positions are primarily fiscal related but involve some phases of program auditing. May occasionally participate as an audit team member on audits in which they are not the designated lead auditor.
Directs and coordinates the activities of an audit team in the review and analysis of a department; provides contracts and/or reimbursement systems for compliance with federal, state, and agency program policies, rules, and laws; develops audit plans, prepares audit guidelines, and prepares correspondence;
Coordinates with program managers, vendors, consultants, and related staff to ensure plans and procedures are comprehensive and accurate;
Visits audit review sites and provides lead assistance to audit team members; advises team members in difficult areas; provides training for unit or team members in areas of assigned responsibility;
Coordinates and conducts pre-audit conferences with team members; evaluates and validates team members' findings; assists team members in writing drafts of their audit reports;
Holds entrance and exit conferences with the involved parties; compiles and writes audit reports formalizing all team members' individual reports; prepares responses or explanations to audit/review findings contested by providers or review subject;
Evaluates allegations of fraud in Medicaid programs and activities; develops cases of Medicaid fraud for prosecution; participates in the preparation of subpoenas; serves subpoenas; participates in interviews of witnesses on both a formal and an informal basis; provides technical advice to investigators, attorneys, and other medical fraud staff with respect to auditing, accounting, and computer applications;
Performs special projects in the area of management analysis and its organizational problems; provides assistance to management in reviewing and analyzing reimbursement methodologies, program operations, and internal control;
Develops written, oral, and visual presentations designed to inform management and program personnel on the current developments within a program as illustrated by audit findings;
Assists program management in development of new or more effective program policies and procedures; provides technical program assistance to local and regional offices as well as community and contract representatives; establishes and maintains consultative relationships with all ongoing DSHS programs;
Senior or specialist positions may lead or supervise lower level staff. However, leadworker positions must lead lower level staff.
There may be instances where individual positions must have additional licenses or certification. It is the employer’s responsibility to ensure the appropriate licenses/certifications are obtained for each position.
Most positions require a Bachelor’s degree in accounting, business or public administration, economics, computer science, or other related field which included 12 semester or 18 quarter hours of college level accounting and three years of professional auditing experience. Professional experience in accounting, auditing, finance, banking, investigation, or other related experience will substitute year for year for education.
A Master’s degree in a related field or a Certified Public Accountant, Internal Auditor, Information System Auditor, or Fraud Examiner will substitute for two years of professional auditing experience. Auditing experience in a specialty program may be required.