Top 15263 Program auditor i Jobs

Auditor/Investigator I
Qlarant —North Dakota
- $47,911 - $71,508 a year
- Full-time
- Remote
- Analysis skills
- Bachelor's degree
- Entry level
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
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
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
Staff Accountant
Manchester Band of Pomo Indians —Point Arena, CA
- $72,800 a year
- Full-time
- Hybrid work
- Background check
- Finance
- Bachelor's degree
- Health insurance
- Dental insurance
Quick Apply
Supervisor, Retirement
Amalgamated Life Insurance —West Harrison, NY
- $60,000 - $62,000 a year
- Weekends as needed
- Hybrid work
- Mid-level
- Office
- Bachelor's degree
- Free parking
- Paid jury duty
Quick Apply
Policy Management ERM Specialist
CONTINENTAL SERVICE GROUP LLC —Fairport, NY
- $62,353.20 - $71,706.18 a year
- 8 hour shift
- Microsoft Word
- Microsoft Excel
- Mid-level
Quick Apply
Retail Banking Manager
Dairy State Bank —Rice Lake, WI
- Full-time
- Background check
- Management
- Customer service
- Health savings account
- Health insurance
Quick Apply
Director of Compliance
Precision Armament —Wellsville, NY
- $65,000 - $90,000 a year
- Full-time
- Management
- 5 years
- Engineering
- Profit sharing
- Health savings account
Quick Apply
1d
Senior Manager, Income Tax Reporting & Provision
Anheuser-Busch —St. Louis, MO
- $106,400 - $159,600 a year
- Full-time
- CPA
- Analysis skills
- GAAP
- Disability insurance
- Health insurance
Medical Coding Auditor
IN Compass Health —Alpharetta, GA
- Full-time
- 5 years
- Acute care experience
- In-person
- Health insurance
- Dental insurance
Quick Apply
Accountant/Auditor
Adelson & Company PC —Pittsfield, MA
- $65,000 - $85,000 a year
- Full-time
- CPA
- Mid-level
- Office
- Health savings account
- Disability insurance
Quick Apply
Quality Assurance Auditor/Inspector
Sam Dong —Delaware, OH
- From $18 an hour
- Full-time
- Background check
- Computer literacy
- Microsoft Office
- Health insurance
- Dental insurance
Quick Apply
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
Audit Manager
Haynie & Company —Littleton, CO
- $110,000 - $145,000 a year
- Full-time
- Hybrid work
- Background check
- CPA
- Bachelor's degree
- Paid parental leave
- Health savings account
Accountant
La Paz County Financial and Administrative Office —Parker, AZ
- $49,046.40 - $72,592.00 a year
- Overnight shift
- Hybrid work
- Background check
- CPA
- Finance
- Health savings account
- Health insurance
Quick Apply
PROJECT ACCOUNTANT
Encompass Community Supports —Culpeper, VA
- $66,000 - $82,500 a year
- Full-time
- Microsoft Word
- System design
- Mid-level
- Paid holidays
- Loan repayment program
Sanitation Supervisor
Butterball LLC —Mount Olive, NC
- Overtime
- Spanish
- English
- Mid-level
Lead EHS Coordinator
INNIO —Waukesha, WI
- In-person
- Senior level
- Associate's degree
Quick Apply
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

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Auditor/Investigator I

Qlarant -
North Dakota

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Job Details

Full-time
$47,911 - $71,508 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 Heathcare 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

Production Manager - 3rd Shift

Coding and Compliance Auditor

Insurance Premium Auditor-Workers' Compensation

Staff Accountant

Supervisor, Retirement

Policy Management ERM Specialist

Retail Banking Manager

Director of Compliance

Senior Manager, Income Tax Reporting & Provision

Medical Coding Auditor

Accountant/Auditor

Quality Assurance Auditor/Inspector

Senior Compliance Specialist - LIHTC/HUD

Audit Manager

Accountant

PROJECT ACCOUNTANT

Sanitation Supervisor

Lead EHS Coordinator

Executive Director

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