Financial Analyst

Job Summary

This role sits within the Medicaid Fraud Control Unit (MFCU) of the District of Columbia Office of the Inspector General (OIG). The unit investigates and prosecutes matters involving fraud in the District Medicaid program, as well as abuse, neglect, or financial exploitation affecting people living in Medicaid-funded healthcare facilities.

Role Overview

The Financial Analyst independently plans, coordinates, and evaluates medical claims, healthcare billing documents, and financial/business records to support criminal investigations. The position works in close partnership with MFCU Special Agents and federal and District prosecutors to determine what evidence should be obtained through Inspector General and/or grand jury subpoenas and, when needed, drafts subpoenas.

Evidence reviewed in this role may include healthcare claims, medical billing records, database files, records from financial institutions or businesses, contracts, expense reports, email communications, and other data formats.

The analyst also rebuilds medical billing claims and incomplete or fragmented financial records related to individuals, private companies, and governmental entities. The work includes spotting irregular billing patterns and financial connections, tracing complex and hidden transactions, and reviewing information from open-source, law enforcement, District, and OIG data sources to support investigative reports and presentations. Findings are then turned into clear reports and presentations for special agents or prosecutors, while maintaining organized source documentation, task records, and files.

Qualifications and Education

Suitable academic backgrounds include undergraduate or graduate study in finance, business administration, economics, accounting, insurance, engineering, mathematics, banking and credit, law, or another closely related field.

Alternatively, applicants may qualify through specialized experience such as financial transaction analysis or medical claims evaluation that requires solid knowledge of corporate finance, financial databases and software, and specialized finance areas such as public finance, securities, international finance, money and securities markets, investments, and banking. The experience should also demonstrate understanding of the financial and management structures, operations, and practices of corporate and other organizations, along with reimbursement systems and claims-processing procedures. One year of specialized experience must be comparable to at least the next lower grade level.

Licenses and Certifications

A Certified Fraud Examiner (CFE) credential is preferred.

Working Conditions

The work is generally performed in an office or cubicle environment with appropriate lighting, heating, and ventilation.

Other Important Details

This is a Career Service position with permanent duration. The pay plan, series, and grade are CS-1160-12.

The role is not part of the Collective Bargaining Unit (non-union). It may be filled at a salary up to Step 4.

This position is classified as Security Sensitive under section 410 of Chapter 4 of the D.C. Personnel Regulations. In addition to the standard suitability review, applicants and incumbents in security-sensitive roles are subject to an enhanced suitability background check.

The District of Columbia Government states that it does not discriminate or retaliate in employment on the basis of race, color, religion, sex, pregnancy, gender identity or expression, national origin, family responsibilities, political affiliation, sexual orientation, marital status, homeless status, disability, genetic information, age, membership in an employee organization, participation in protected activity, parental status, matriculation, personal appearance, credit information, status as a victim or family member of a victim of domestic violence, sexual offense, or stalking, military service, or any other non-merit factor.

Submitting only a resume is not enough to complete the application. Additional forms and/or supplemental materials may be required, and failure to provide them may result in the application not being considered.

Location

Washington, DC