Top 2796 Data quality auditor Jobs

Auditor/Investigator II
Qlarant —Remote
- $56,055 - $83,665 a year
- Full-time
- Remote
- Mid-level
- Analysis skills
- Bachelor's degree
Quick Apply
Medical Coding Auditor
IN Compass Health —Alpharetta, GA
- Full-time
- 5 years
- Acute care experience
- In-person
- Health insurance
- Dental insurance
Quick Apply
Quality Auditor
Maysteel Industries LLC —Frederick, CO
- $21 - $25 an hour
- Full-time
- High school diploma or GED
- US work authorization
- Cleaning
- Health savings account
- Health insurance
Quick Apply
Sales Tax Supervisor
Les Schwab Warehouse Center, LLC —Bend, OR
- Full-time
- CPA
- 5 years
- Bachelor of Science
Quick Apply
10d
QA Auditor - Manufacturing (Nights)
Chelsea Building Products —Oakmont, PA
- $18.50 - $20.27 an hour
- 12 hour shift
- High school diploma or GED
- In-person
- Communication skills
- Health insurance
- Dental insurance
Quick Apply
Coding and Compliance Auditor
South Shore Health —Weymouth, MA
- $73,000 - $104,400 a year
- Full-time
- Hybrid work
- 5 years
- Mid-level
- Acute care experience
Senior Accountant
Magnus Capital Partners —Grand Rapids, MI
- Up to $75,000 a year
- Full-time
- Background check
- CPA
- 5 years
- Disability insurance
- Health insurance
Quick Apply
Quality Compliance Auditor
Camco Chemical —Florence, KY
- Ability to climb stairs
- Ability to lift 50 pounds
- Bachelor's degree
Director of Audit and Compliance
Denver Housing Authority —Denver, CO
- $117,740.45 - $147,175.95 a year
- Weekends as needed
- Hybrid work
- Background check
- Basic math
- Research
- Health insurance
- Dental insurance
Quick Apply
Accounting Specialist
Jefferson City Medical Group (JCMG) —Jefferson City, MO
- Full-time
- Microsoft Word
- Computer literacy
- High school diploma or GED
- Paid holidays
- Disability insurance
Quick Apply
10d
Insurance Premium Auditor-Workers' Compensation
SFM Mutual Insurance Company —Bloomington, MN
- $28.70 - $40.18 an hour
- Full-time
- Hybrid work
- Ability to walk for extended periods
- Word processing
- Mid-level
- Paid parental leave
- Health savings account
Senior Accountant
A.P. Croll & Son Inc. —Georgetown, DE
- $90,000 - $110,000 a year
- Full-time
- Background check
- Office
- 3 years
- Health insurance
- Dental insurance
Quick Apply
Auditor - GVP
CSL Behring —King of Prussia, PA
- Full-time
- Up to 50% travel
- Bachelor of Science
- Mid-level
Quality Auditor
AdTech Ceramics Company —Chattanooga, TN
- From $17 an hour
- Overtime
- Computer literacy
- Basic math
- High school diploma or GED
- Health insurance
- Dental insurance
Quick Apply
Enrolled Agent – Tax & Accounting Specialist (Full-Time)
MPC Financial Corporation —Lincoln Park, MI
- $62,400 - $72,800 a year
- Full-time
- Background check
- Spanish
- English
- Continuing education credits
- Health insurance
Quick Apply
1d
Admin Representative
DeeSonii's —Tamuning, GU
- Full-time
- Mid-level
- Office
- Administrative experience
Quick Apply
10d
Staff Accountant
Hayden Ross, PLLC —Moscow, ID
- From $60,000 a year
- Full-time
- Data analysis skills
- Mid-level
- Office
- Health savings account
- Health insurance
Quick Apply
3d
Call Center Quality Assurance Auditor
United Faith Ministries Inc —Orange, CA
- $26 an hour
- Full-time
- Spanish
- HIPAA
- English
- 403(b) matching
- Health insurance
Quick Apply
Auditor - GLP
CSL Behring —King of Prussia, PA
- Full-time
- Up to 50% travel
- Bachelor of Science
- Laboratory experience
Senior Finance Auditor
Fortune Brands —Deerfield, IL
- $80,000 - $126,500 a year
- Full-time
- Spanish
- Oracle
- CPA
- Health insurance
- Adoption assistance
Quick Apply

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Auditor/Investigator II

Qlarant -
Remote

Quick Apply

Job Details

Full-time
$56,055 - $83,665 a year

Qualifications

Medicaid regulations
Medicaid
Stakeholder management

Full Job Description

Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed care organization quality review, and quality assurance for programs serving individuals with developmental disabilities. Qlarant is also a national leader in fighting fraud, waste and abuse for large organizations across the country. In addition, our Foundation provides grant opportunities to those with programs for underserved communities.

Best People, Best Solutions, Best Results

Job Summary:

Ensures the integrity and accuracy of claims processes and protocols. Collects data for audits/investigations into claims, utilizing a combination of analytical skills and attention to detail, reviewing documentation, interviewing involved parties, and communicating with various stakeholders to gather relevant information for successful resolution and closure. Identifies opportunities to target fraud, waste, and abuse or discrepancies in claims submissions. Adheres to industry regulations and policies for managerial follow-up. Analyzes data in order to effectively assess the validity of claims. Provides accurate recommendations to management for claim resolution and closure. Documents and inputs all findings, while preparing comprehensive reports that may be used for legal or audit/investigative purposes.

Essential Functions:

Conducts routine and impartial audits/investigations from start to closure into customer claims, ensuring accurate and fair assessments of claims validity.
Provides customer service by addressing inquiries and concerns, and escalates audit/investigation, as needed.
Compiles detailed and organized records of audit/investigation findings, ensuring accuracy and compliance with legal and regulatory requirements.
Applies functional knowledge to create and implement strategies to identify and prevent fraudulent activities, safeguarding the integrity of the claims process.
Conducts interviews with relevant witnesses, claimants, and other stakeholders to gather additional information and perspectives on claims.
Communicates with appropriate internal teams to ensure the proper processing of audits/investigations, while adhering to legal and regulatory standards.
Communicates audit/investigation findings clearly and professionally to customers, claimants, and other stakeholders, managing expectations and providing updates.
Assists in providing training and support to other auditors/investigators, contributing to the continuous improvement of investigative processes.

Level of Supervision Received:
Plans and arranges own work; works with manager to prioritize projects.

Education (can be substituted for experience):
Minimum Bachelor's Degree required

Work Experience (can be substituted for education):
2 - 4 years of experience required; 5 - 7 years preferred
Prior experience with Medicaid required

Certification(s):
Certified Fraud Examiner preferred

Qlarant is an Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities.

Qlarant is a drug-free workplace. All offers of employment are contingent upon successful completion of pre-employment background and drug screens.

Quick Apply

Refine Your Search

data quality auditor jobs

Auditor/Investigator II

Medical Coding Auditor

Quality Auditor

Sales Tax Supervisor

QA Auditor - Manufacturing (Nights)

Coding and Compliance Auditor

Senior Accountant

Quality Compliance Auditor

Director of Audit and Compliance

Accounting Specialist

Insurance Premium Auditor-Workers' Compensation

Senior Accountant

Auditor - GVP

Quality Auditor

Enrolled Agent – Tax & Accounting Specialist (Full-Time)

Admin Representative

Staff Accountant

Call Center Quality Assurance Auditor

Auditor - GLP

Senior Finance Auditor

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