Top 16552 Program auditor i Jobs

Auditor/Investigator I
Qlarant —Remote
- $65,000 - $70,000 a year
- Full-time
- Remote
- Analysis skills
- Bachelor's degree
- Entry level
Quick Apply
Compliance Specialist $20-$26/hr with Overtime Potential (LIHTC/Affordable Housing Exp Req; Remote)
Zeffert & Associates, Inc. —Remote
- $20 - $26 an hour
- Overtime
- Travel
- Entry level
- Health insurance
- Dental insurance
Quick Apply
HR & Finance Generalist
AEM —Remote
- $25 - $45 an hour
- Part-time
- Remote
- Mid-level
- Finance
- Administrative experience
- Health savings account
- Health insurance
Quick Apply
13d
Auditor I
Palm Beach County —West Palm Beach, FL
- $69,950 a year
- Monday to Friday
- CPA
- Computer Science
- Mid-level
Auditor
Contact Government Services, LLC —Remote
- $50,000 - $100,000 a year
- Full-time
- Hybrid work
- Microsoft Excel
- Mid-level
- 3 years
- Health insurance
- Dental insurance
Quick Apply
Production Manager - 3rd Shift
Norwich Pharmaceuticals Inc —Norwich, NY
- $85,000 - $95,000 a year
- Full-time
- Bachelor of Science
- Employment & labor law
- 3 years
- Wellness program
- Health savings account
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
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
Production Quality Engineer
Nifco America, Corp. —Canal Winchester, OH
- $65,000 - $80,000 a year
- Full-time
- Background check
- Microsoft Excel
- Writing skills
- Health savings account
- Relocation assistance
Quick Apply
Accounting Manager
Lac du Flambeau Business Development Corp —Lac du Flambeau, WI
- From $100,000 a year
- Full-time
- Microsoft Excel
- CPA
- Pass drug screening
Quick Apply
8d
Executive Director
Captiva Erosion Prevention District —Captiva, FL
- $120,000 - $130,000 a year
- Full-time
- Background check
- Office
- Administrative experience
- Health insurance
- Dental insurance
Quick Apply
Accounts Payable Manager
SNF Holding Company —Riceboro, GA
- Full-time
- Writing skills
- Office
- Finance
- Paid holidays
- Disability insurance
Senior Compliance Specialist - LIHTC/HUD
Quality Management Group Inc —Ontario, CA
- $33 - $37 an hour
- Extended hours
- Microsoft Word
- Microsoft Outlook
- Customer service
Quick Apply
Quality & Food Safety Systems Manager
Izzio Artisan Bakery LLC —Louisville, CO
- $75,000 - $90,000 a year
- Weekends as needed
- 5 years
- Writing skills
- Bachelor's degree
- Paid holidays
- Health insurance
Quick Apply
Compliance Officer / Loan Administration Officer (5 yrs experience required)
Farmers State Bank Pine Bluffs —Pine Bluffs, WY
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Office
- Disability insurance
- Health insurance
Quick Apply
12d
Human Resources Manager
Fibre Converters, Inc. —Constantine, MI
- $68,041.39 - $81,942.31 a year
- Full-time
- Management
- Mid-level
- Recruiting
- Health savings account
- Health insurance
Quick Apply
Quality Engineer - II
AGC/ GarKenyon —Meriden, CT
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Writing skills
Quick Apply
Underwriter/Senior Underwriter
CIS Trust —Wilsonville, OR
- $100,092 - $137,311 a year
- Online Application
- Hybrid work
- Background check
- 5 years
- Public speaking
- Health insurance
- Dental insurance
6d
Quality Supervisor
Copeland —Natchitoches, LA
- Full-time
- Engineering
- Mid-level
- Residential
- Paid parental leave
- Paid holidays

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Auditor/Investigator I

Qlarant -
Remote

Quick Apply

Job Details

Full-time
$65,000 - $70,000 a year

Qualifications

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:

Serves as an entry level professional who develops baseline plans for ensuring 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 company 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 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.
Ensures that all audit and investigative documents and records are processed into the database in a timely and accurate manner.
Communicates audit/investigation findings clearly and professionally to customers, claimants, and other stakeholders, managing expectations and providing updates.
Supports management in regular audit and investigation proceedings, ensuring full compliance with all applicable regional and federal standards, regulations, and protocols.

Level of Supervision Received:
Under general supervision, proceeds alone on regular duties, referring questionable cases to manager.

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

Work Experience (can be substituted for education):
0 - 2 years of experience required; 2 - 4 years preferred

Certification(s):
Certified Fraud Examiner or Accredited Healthcare Anti-Fraud Investigator 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

program auditor i jobs

Auditor/Investigator I

Compliance Specialist $20-$26/hr with Overtime Potential (LIHTC/Affordable Housing Exp Req; Remote)

HR & Finance Generalist

Auditor I

Auditor

Production Manager - 3rd Shift

Medical Coding Auditor

Coding and Compliance Auditor

Senior Accountant

Production Quality Engineer

Accounting Manager

Executive Director

Accounts Payable Manager

Senior Compliance Specialist - LIHTC/HUD

Quality & Food Safety Systems Manager

Compliance Officer / Loan Administration Officer (5 yrs experience required)

Human Resources Manager

Quality Engineer - II

Underwriter/Senior Underwriter

Quality Supervisor

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