Fraud pada Program Jaminan Kesehatan Nasional Perpekstif: Kompetensi Auditor Internal dengan Pendekatan Fenomenologi
Abstrak
This study aims to analyze the competence of the Internal Auditor with a phenomenological
approach to preventing and detecting fraud in the JKN program at RSUD Andi Makkasau
Parepare. This study uses a qualitative method with a phenomenological approach to the Internal
Supervisory Unit at Andi Makkasau Hospital Parepare by using documentation and interviews
with SPI, Internal Verifiers, and Koder. The researcher uses the internal auditor core competency
framework compiled by The Institute of Internal Auditors (IIA) to analyze descriptively with
Epoche, phenomenological reduction, imaginative variation, and draw conclusions on the ability
to prevent and detect JKN program fraud. The results showed that the Internal Auditor of SPI
RSUD Andi Makkasau Parepare in preventing and detecting fraud has not yet been tested for
quality because the competencies that have been mastered have not been utilized properly. The
Internal Auditor of SPI is still running other programs as the Healthcare Incentive Verification
Team during the pandemic. In practice, indications of fraud in the JKN program are primarily
disclosed by Internal Verifiers and Coders. However, the Fraud Team has not followed up on this
because they feel they have never found a fraud case that disrupted health services.
Keywords: Fraud, Jaminan Kesehatan Nasional (JKN), Kompetensi Auditor Internal.
approach to preventing and detecting fraud in the JKN program at RSUD Andi Makkasau
Parepare. This study uses a qualitative method with a phenomenological approach to the Internal
Supervisory Unit at Andi Makkasau Hospital Parepare by using documentation and interviews
with SPI, Internal Verifiers, and Koder. The researcher uses the internal auditor core competency
framework compiled by The Institute of Internal Auditors (IIA) to analyze descriptively with
Epoche, phenomenological reduction, imaginative variation, and draw conclusions on the ability
to prevent and detect JKN program fraud. The results showed that the Internal Auditor of SPI
RSUD Andi Makkasau Parepare in preventing and detecting fraud has not yet been tested for
quality because the competencies that have been mastered have not been utilized properly. The
Internal Auditor of SPI is still running other programs as the Healthcare Incentive Verification
Team during the pandemic. In practice, indications of fraud in the JKN program are primarily
disclosed by Internal Verifiers and Coders. However, the Fraud Team has not followed up on this
because they feel they have never found a fraud case that disrupted health services.
Keywords: Fraud, Jaminan Kesehatan Nasional (JKN), Kompetensi Auditor Internal.