COMPLIANCE/AUDIT INVESTIGATOR 3

<p><strong>This recruitment is open to current classified State employees in the Department of  Business and Industry who have served at least 6 months of continuous full-time equivalent service in a classified position. </strong> </p><p data-pasted="true">The Department of Business and Industry is recruiting to fill a Compliance/Audit Investigator 3 position within the Workers' Compensation Section of the Division of Industrial Relations in Las Vegas. The incumbent oversees statewide subsequent injury claims by reviewing case files and reimbursement requests for accuracy and compliance with NRS 616A–D and by preparing formal determinations for management and review boards. The incumbent coordinates review board hearings, provides technical guidance and training to administrative and investigative staff, maintains accurate CARDS documentation, and ensures all statutory and regulatory deadlines are met. The role also collaborates with insurers and TPAs, represents the Division in outreach and industry events, and supports operational efficiency through process improvements and cross-functional backup.</p>Bachelor's degree from an accredited college or university in business or public administration, business management, accounting, or related field and three years of professional experience in an investigative, auditing or program-related position which required the application of federal and/or State 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 five years of experience, three of which were in a professional investigative, auditing or professional program-related position which required the application of federal and/or State 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 one year of experience as a Compliance/Audit Investigator II in Nevada State service; OR an equivalent combination of education and experience as described above.Enforcement powers regarding program violations are limited to a specific program area that involves administrative sanctions or penalties imposed by the federal government, State official or a Hearings Board. Criminal violations are referred to the appropriate criminal justice agency for prosecution. This series is distinguished from other investigative classes by the additional audit function which is performed at least 25% of the time. Audit work is performed in a specialized field which requires an extensive knowledge of federal and/or State laws, program rules and regulations; business operations; corporate structure; financial transactions, terminology and recordkeeping; and detecting falsified records and/or program violations. Violations may be elaborately planned and sophisticated in nature requiring extensive research and analysis to detect. <br> <br>Receive and review formal complaints; make determinations regarding possible program violations and jurisdiction within the specified program area; gather and analyze background information and facts pertaining to the complaint; make determinations regarding the extent of violations, and recommendations to initiate a formal investigation. <br> <br>Conduct interviews with complainant, witnesses, employers, State and local government agencies and other sources to obtain information regarding violations or noncompliance and develop leads and facts pertaining to the case to prove a violation or criminal intent exists. <br> <br>Prepare required forms and notices; deliver to appropriate party regarding complaint and/or alleged violations following department policy and procedure; respond, review and discuss with complainant and respondent. <br> <br>Develop case files and maintain case logs and reports; place evidence in case file along with chronological documentation regarding investigative steps taken and all contact made with complainant, respondent, witnesses and other sources; preserve and utilize evidence to develop final case reports and/or for future litigation. <br> <br>Gather and review evidence such as business and financial records, service contracts, professional reports, bank statements, billing documents, sales transactions, client account records, personnel files and historical data pertaining to the suspected violation to develop trends, patterns and to support complaint; serve subpoenas or other legal documents as required. <br> <br>Conduct audits on a periodic basis by either randomly selecting individual firms or business or as required by State law and reviewing business transactions for completeness, accuracy, and compliance with federal and/or State laws and regulations; evaluate internal procedures, operating methods, fiscal controls, and verify validity of financial statements and records; explain provisions and application of federal and/or State guidelines and discuss assessments, audit findings and recommendations. <br> <br>Prepare required forms and notices and send to appropriate parties regarding complaint and alleged violations; review and discuss responses with supervisor and/or Attorney General. <br> <br>Conduct research regarding program rules, court decisions, industry practices and standards, procedures and techniques to ensure compliance, and to develop or revise program regulations or policies; plan and coordinate investigations and audits to determine whether administrative and/or criminal action should be taken. <br> <br>Prepare investigative and audit reports encompassing results of examination of accounting records, known violations, statement of facts, case summary, and exhibits of evidence, statements obtained from witnesses, conclusions and recommendations; review and submit reports for hearing or prosecution, and to impose fines and penalties; appear before the governing body or in a court of law to provide testimony as required. <br> <br>Perform related duties as assigned. <br> <br>Under limited supervision, incumbents act as a leadworker on a regular reoccurring basis and perform specialized investigative/audit functions dealing with complex and/or multiple program violations and/or criminal activity. Extensive knowledge of federal and/or State laws, case law, program regulations, industry standards, concepts and practices is required to conduct detailed investigations and audits.<strong>Working knowledge of: </strong>civil law and related criminal law to enforce program regulations as well as to ensure federal and State compliance; methods and practices of effective investigations and what constitutes legal evidence; recordkeeping practices to obtain and store needed investigative reports and documents; computer usage and program-related terminology to access and input required data. <br><br><strong>Ability to:</strong> prioritize numerous assignments and make needed adjustments; work independently with minimal supervision; maintain equanimity in the face of resistance, indifference and hostility; resolve complaints from consumers, business representatives and other State and local agencies; delegate responsibility.