Top 15031 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
Auditor, Compliance (Remote in FL)
Molina Healthcare —Florida
- $54,922 - $107,099 a year
- Full-time
- Remote
- Mid-level
- Analysis skills
- 2 years
- Health insurance
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
Sales Tax Auditor
South Dakota State Government —Aberdeen, SD
- $26.84 an hour
- Online Application
- Microsoft Outlook
- Writing skills
- Mid-level
- Health savings account
- Paid holidays
14d
Assistant Real Property Lister and Real Estate/Vital Records Clerk
Ashland County —Ashland, WI
- $18.57 - $20.16 an hour
- Full-time
- Office
- In-person
- 1 year
- Health insurance
- Dental insurance
Quick Apply
13d
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
Quality Manager
Foamtec International Co. —Waco, TX
- Full-time
- Microsoft Outlook
- 5 years
- Bachelor's degree
- 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
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
Corporate Securities Attorney (5+ Years)
Meister Seelig & Fein PLLC —New York, NY
- $180,000 - $220,000 a year
- Full-time
- 5 years
- Office
- In-person
- Health savings account
- 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
Open Doors, Inc. —Lewisburg, WV
- From $26 an hour
- Full-time
- Background check
- Management
- HIPAA
- Disability insurance
- Health insurance
Quick Apply
6d
Accounting Manager
Gerdau —Jackson, MI
- From $136,960 a year
- Full-time
- Microsoft Excel
- CPA
- Finance
- Health savings account
- Disability insurance
Quick Apply
13d
Quality Engineer
Crane Aerospace & Electronics —Elyria, OH
- Full-time
- Background check
- Microsoft Outlook
- Bachelor of Science
- Paid holidays
- Disability insurance
I&E Supervisor
Continental Carbon —Ponca City, OK
- Full-time
- Background check
- 5 years
- Mid-level
- Relocation assistance
- Health insurance
Quick Apply
Finance Director
Consolidated Tribal Health Project, Inc. —Redwood Valley, CA
- $127,753 - $169,520 a year
- Full-time
- Background check
- CPA
- Current TB test
- COVID-19 protective measures
- Relocation assistance
Quick Apply
11d
Quality Manager
DRC Heat Transfer —Melrose Park, IL
- Full-time
- Background check
- Management
- Bachelor's degree
- Health savings account
- Health insurance
Quick Apply
Senior Information Security Lead
Genesis Capital LLC —Sherman Oaks, CA
- $125,000 - $165,000 a year
- Full-time
- Computer science
- 7 years
- Azure
- Health savings account
- Health insurance
Quick Apply
Controller
The Confidential Search Company —Boston, MA
- Up to $175,000 a year
- Full-time
- Microsoft Word
- Background check
- Microsoft Excel
- Disability insurance
- Health insurance
Quick Apply
Chief Financial Officer
Team Allied Distribution —Fairfield, CA
- $160,000 - $180,000 a year
- Full-time
- Spanish
- 7 years
- Microsoft Excel
- AD&D insurance
- Health 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

Auditor, Compliance (Remote in FL)

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

Sales Tax Auditor

Assistant Real Property Lister and Real Estate/Vital Records Clerk

Audit Manager

Quality Manager

Coding and Compliance Auditor

Policy Management ERM Specialist

Corporate Securities Attorney (5+ Years)

Production Quality Engineer

Accounting Manager

Accounting Manager

Quality Engineer

I&E Supervisor

Finance Director

Quality Manager

Senior Information Security Lead

Controller

Chief Financial Officer

I want to receive the latest job alert for program auditor i

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