Top 596 Auditor/investigator i Jobs

Auditor/Investigator I
Qlarant —Remote
- $65,000 - $70,000 a year
- Full-time
- Remote
- Analysis skills
- Bachelor's degree
- Entry level
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Auditor/Investigator II
Qlarant —Remote
- $57,512 - $85,839 a year
- Full-time
- Remote
- Mid-level
- Analysis skills
- Bachelor's degree
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Compliance Billing Auditor/Investigator
Aspire of WNY —Cheektowaga, NY
- $23.95 - $28.31 an hour
- Full-time
- Background check
- Mid-level
- Office
- Continuing education credits
- 403(b) matching
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Internal Auditor
Barber National Institute —Erie, PA
- Full-time
- 18 years or older
- Research
- Mid-level
8d
Regulatory Specialist
Rare Disease Research —Brookhaven, GA
- $55,000 - $70,000 a year
- 8 hour shift
- CPR Certification
- BLS Certification
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Chief Deputy Legal Counsel
North Carolina Real Estate Commission —Raleigh, NC
- $90,624 - $108,749 a year
- Full-time
- Writing skills
- Office
- In-person
- Paid parental leave
- Paid holidays
Quick Apply
5d
Auditor - GCP
CSL Behring —King of Prussia, PA
- Full-time
- Up to 50% travel
- Bachelor of Science
- Mid-level
Quality Assurance Nurse - Clinical Trials
Stony Brook University Hospital —Stony Brook, NY
- $89,760 - $131,975 a year
- Online Application
- Nursing
- RN License
- 5 years
6d
Quality Assurance Auditor III
INOTIV INC —West Lafayette, IN
- Full-time
- Bachelor of Science
- Bachelor's degree
- Senior level
- Paid parental leave
- Disability insurance
Quick Apply
CPI Special Investigator Trainee
Dept of Family & Protectve Svc —Denton, TX
- $4,748.95 - $5,921.25 a month
- Online Application
- Background check
- Military
- Writing skills
- Paid holidays
- Dental insurance
Quick Apply
CPI Special Investigator Trainee
Dept of Family & Protectve Svc —Fort Stockton, TX
- $4,748.95 - $5,921.25 a month
- Online Application
- Background check
- Writing skills
- Office
- Paid holidays
- Dental insurance
Quick Apply
Child in Need of Care (CNC) Caseworker- DHSS Social Services
Colorado River Indian Tribes —Parker, AZ
- Up to $22.42 an hour
- Weekends as needed
- Background check
- Pass drug screening
- HIPAA
- Paid holidays
- Health insurance
Quick Apply
CPI Investigation Worker Trainee
Dept of Family & Protectve Svc —Corpus Christi, TX
- $3,816.65 - $5,372.41 a month
- Weekends as needed
- Background check
- Clean driving record
- Computer literacy
- Paid holidays
- Dental insurance
Quick Apply
6d
Clinical Research Nurse Practitioner (APRN) or Physician Associate (PA-C)
Conquest Research —Winter Park, FL
- $100,000 - $120,000 a year
- Full-time
- Spanish
- Writing skills
- English
- Health insurance
- Dental insurance
Quick Apply
2d
Clinical Research Coordinator (Phlebotomy)
Segal Institute for Clinical Research —Lauderhill, FL
- Full-time
- Vital signs
- Psychiatry
- Addiction Medicine
- Health insurance
- Dental insurance
Quick Apply
Clinical Research Coordinator
Segal Institute for Clinical Research —North Miami, FL
- Full-time
- Bilingual
- Vital signs
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Clinical Research Coordinator
Segal Institute for Clinical Research —Boynton Beach, FL
- Full-time
- Vital signs
- Research
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Senior Auditor Investigator
Georgia State University —Atlanta, GA
- $89,300 - $116,000 a year
- Full-time
- Background check
- CPA
- 5 years
- Health insurance
- Dental insurance
Civil Rights Investigator/Auditor
Contact Government Services, LLC —Cleveland, OH
- $75,000 - $110,000 a year
- Full-time
- 6 years
- Databases
- Senior level
- Health insurance
- Dental insurance
Quick Apply
Securities Enforcement Auditor I
Illinois Secretary of State —Chicago, IL
- $4,695 - $8,304 a month
- Online Application
- Writing skills
- Mid-level
- Office
Quick Apply
6d

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Auditor/Investigator I

Qlarant -
Remote

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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

auditor/investigator i jobs

Auditor/Investigator I

Auditor/Investigator II

Compliance Billing Auditor/Investigator

Internal Auditor

Regulatory Specialist

Chief Deputy Legal Counsel

Auditor - GCP

Quality Assurance Nurse - Clinical Trials

Quality Assurance Auditor III

CPI Special Investigator Trainee

CPI Special Investigator Trainee

Child in Need of Care (CNC) Caseworker- DHSS Social Services

CPI Investigation Worker Trainee

Clinical Research Nurse Practitioner (APRN) or Physician Associate (PA-C)

Clinical Research Coordinator (Phlebotomy)

Clinical Research Coordinator

Clinical Research Coordinator

Senior Auditor Investigator

Civil Rights Investigator/Auditor

Securities Enforcement Auditor I

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