Auditor – Forensic Accounting & Investigations

Auditor – Forensic Accounting & Investigations

We are seeking an experienced Auditor/Forensic Accountant to support complex government investigations and litigation. This role will work under the direction of client attorneys and provide financial, accounting, data analysis, and investigative expertise in matters involving healthcare fraud, government program fraud, financial damages, and other complex civil and criminal investigations.

The Auditor will conduct medical claims analysis, forensic financial investigations, statistical sampling, damages calculations, and ability-to-pay analyses that may directly support investigative, prosecution, settlement, and recovery decisions.

Due to the sensitive nature of the work, the Auditor will handle confidential financial, investigative, grand jury, sealed litigation, and individually identifiable healthcare information.

• Active Certified Public Accountant (CPA) credential required

• MBA or equivalent advanced degree in Accounting or a directly related field

• Thorough knowledge of Generally Accepted Accounting Principles (GAAP)

• Thorough knowledge of Generally Accepted Auditing Standards (GAAS)

• Minimum 3 years of professional auditing experience

• Minimum 2 years of specialized experience in the relevant subject-matter area, such as:

  • Medicare/healthcare billing and claims systems

  • Government program fraud

  • DoD inventory or procurement systems

  • Similar complex financial or accounting environments

• Experience analyzing complex financial and accounting data

• Working knowledge of appropriate accounting and financial-analysis systems and applications

• Excellent written and verbal communication skills

• Ability to analyze complex information and clearly communicate findings to attorneys, investigators, and other stakeholders

• Ability to handle highly sensitive and confidential investigative information

Preferred:

• Experience working in a litigation or investigative environment

• Experience with automated litigation support tools

• Healthcare claims or Medicare/Medicaid data analysis experience

• Forensic accounting or fraud investigation experience

• Conduct comprehensive audits and financial analyses in support of civil and criminal investigations and litigation.

• Analyze personal and business financial records to identify:

  • Suspicious payments and kickbacks

  • Sources and uses of funds

  • Money flows

  • Related-party transactions

  • Potential financial damages

• Perform asset valuations, financial-record reconstruction, and other forensic accounting analyses.

• Develop computerized financial models for use in investigations and presentations of financial evidence.

• Conduct financial investigations to determine the ability of individuals and organizations to satisfy settlements and judgments.

• Review, analyze, and interpret large and complex datasets, including:

  • Centers for Medicare & Medicaid Services (CMS) claims data

  • PPP loan data

  • Healthcare fraud records

  • Defense procurement records

  • Other government program data

• Identify unusual billing activity, outliers, anomalies, trends, and patterns within healthcare claims.

• Normalize claims data across multiple benefit plans to support analytical assessments and time studies.

• Analyze investigative and discovery records to identify patterns and test data under different scenarios.

• Reinterpret and extrapolate results from Statistically Valid Random Samples when sample-review outcomes change.

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

• Analyze assets, liabilities, debt covenants, borrowing capacity, earnings, financial ratios, aging schedules, tax considerations, and collectability.

• Prepare clear and defensible calculations supporting potential damages, settlements, judgments, and recoveries.

• Support investigations involving the government's affirmative civil enforcement of federal laws, including matters involving the:

  • False Claims Act

  • Anti-Kickback Statute

  • Stark Law

• Support criminal financial investigations involving fraud, theft of government funds, healthcare fraud, wire/mail fraud, and money laundering.

• Prepare clear, accurate reports summarizing financial analyses, data findings, methodologies, and evidentiary conclusions.

• Communicate investigative findings to attorneys, investigators, and other members of the legal team.

• Provide recommendations regarding investigative strategies, areas requiring additional review, and potential courses of action.

• Review defense presentations, expert reports, and related litigation materials.

• Collaborate with independent experts when necessary.

• Prepare expert reports for litigation and participate in negotiations when requested.

• Professionally engage with witnesses, persons of interest, and representatives from local, state, and federal agencies.

• Obtain and clarify information, establish…