Top 42 Auditor Jobs in Worcester, Ma

Medical Program Auditor/ Analyst
University of Massachusetts Medical School —Westborough, MA
- $80,000 - $95,000 a year
- Full-time
- Microsoft Excel
- Customer service
- Mid-level
Medical Billing Code Auditor- Healthcare Internal Audit - Hybrid work schedule
Fallon Health —Worcester, MA
- $87,500 a year
- Full-time
- Hybrid work
- Writing skills
- Mid-level
- 3 years
Senior Audit Specialist, Trade Compliance
TJX Companies —Marlborough, MA
- $85,600 - $109,200 a year
- Full-time
- Office
- Bachelor's degree
- Senior level
- Health savings account
- Paid holidays
Accountant I, Student Accounts (OneCard) - Worcester State University
Worcester State University —Worcester, MA
- $2,152.54 a month
- Full-time
- Management
- Office
- Math
- Paid holidays
- Disability insurance
9d
Senior Internal Auditor
Waters Corporation —Milford, MA
- $82,000 - $137,000 a year
- Hybrid work
- CPA
- Mid-level
- Finance
Accounting Manager
R.H. White Construction —Auburn, MA
- $95,615 - $120,000 a year
- Full-time
- CPA
- Writing skills
- ERP systems
- Health insurance
- Dental insurance
Quick Apply
7d
Accountant
Health Plans Inc —Westborough, MA
- $29 - $32 an hour
- Full-time
- Writing skills
- Mid-level
- Office
- Health savings account
- Health insurance
Quick Apply
8d
Sr. Internal Audit Manager
IPG Photonics —Marlborough, MA
- $131,000 - $162,000 a year
- Full-time
- Management
- CPA
- ERP systems
- Health savings account
- AD&D insurance
Quick Apply
Senior Accountant II
MutualOne Bank —Framingham, MA
- $63,549 - $97,512 a year
- Full-time
- Hybrid work
- Oracle
- CPA
- Mid-level
Quick Apply
Staff / Project Accountant
BSC Group —Worcester, MA
- Full-time
- Hybrid work
- 5 years
- Mid-level
- Finance
Quick Apply
2d
Senior Accountant/Auditor
Spinelli CPA PC —Worcester, MA
- $33 - $45 an hour
- Full-time
- Hybrid work
- CPA
- Research
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
1d
Auditor
ScrubaDub Auto Wash Centers Inc. —Natick, MA
- 8 hour shift
- Computer literacy
- Office
- High school diploma or GED
- Health insurance
- Dental insurance
Quick Apply
2d
Manager, Accounting & SEC Reporting
Divert —Concord, MA
- $110,000 - $160,000 a year
- Hybrid work
- 8 years
- Analysis skills
- Senior level
- Health insurance
- Dental insurance
Quick Apply
Staff Accountant
Lynch Marini & Associates —Natick, MA
- Year round work
- CPA
- Mid-level
- Office
- Opportunities for advancement
Outsourced Accounting Manager - Life Science
CITRIN COOPERMAN ADVISORS LLC —Worcester, MA
- $90,000 - $200,000 a year
- Full-time
- Remote
- 6 years
- Management
- CPA
Controller
Massachusetts Technology Collaborative —Westborough, MA
- $125,000 - $135,000 a year
- Full-time
- Hybrid work
- Management
- Office
- Analysis skills
- Health insurance
- Dental insurance
Quick Apply
14d
Accountant Analyst
Parker Hannifin Corporation —Devens, MA
- $87,050 - $145,250 a year
- Full-time
- Bachelor of Science
- Research
- Mid-level
- Paid parental leave
- Paid holidays
Home Energy Auditor
Worcester Community Action Council Inc —Worcester, MA
- $21 - $25 an hour
- Background check
- Customer service
- Pass drug screening
- Paid holidays
- Disability insurance
Quick Apply
Account Manager - IPM Auditing Exp Req
Braman Termite & Pest Elimination —Auburn, MA
- $60,000 - $70,000 a year
- Basic math
- Mid-level
- Ability to lift 50 pounds
Quick Apply
Audit & Assurance Manager
Innovative CPA Group LLC —Worcester, MA
- $85,000 - $100,000 a year
- Full-time
- Hybrid work
- 7 years
- CPA
- Research
- Health insurance
- 401(k) matching
Quick Apply

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Medical Program Auditor/ Analyst

University of Massachusetts Medical School -
Westborough, MA

Apply Now

Job Details

Full-time
$80,000 - $95,000 a year

Qualifications

Customer communication
Bachelor's degree
Data-driven problem-solving

Full Job Description

Overview:

Under the general direction of the Associate Director or designee, the Fraud, Waste, and Abuse (FWA) Auditor serves a crucial role in identifying, investigating, and preventing fraud, waste and abuse for Medicaid programs. A major function of this position is to conduct desk and onsite audits across various provider types to ensure compliance with federal and state regulations. The Auditor performs investigative activities to develop leads and detect aberrant billing practices, including data mining, claims analysis, and medical record assessment.

Onsite requirement 1-2 times per month, all other aspects of the job are remote.

Responsibilities:

Responsibilities:

Ensure compliance with federal and state regulations and healthcare FWA industry standards.
Perform independent data mining and data analysis utilizing claims data to detect patterns and trends that may uncover fraud, waste, or non-compliant billing practices.
Conduct onsite audits as required, to assess the completeness of medical and administrative records and the compliance with applicable regulatory requirements.
Prepare detailed audit documentation, summaries of investigative findings, compile case files, calculate sanctions and overpayments based on violations cited.
Communicate with providers regarding issues such as general regulatory compliance, audit findings, and the recovery process.
Recommend policy, procedure and system changes to enhance investigative outcomes.
Update appropriate internal management staff regularly on progress of investigations.
Stay current with regulatory updates, coding changes, and industry standards.
Identify trends from national fraud-related publications and recommend new or improved strategies to strengthen fraud-detection efforts.
Assist with document management, updating case-tracking system and adhering to record retention policies and procedures.
Perform other duties as assigned.

Qualifications:

Qualifications:

Bachelor's degree in business, health care administration, or other related field
4-6 years of related experience in the healthcare industry, business,; with at least two years of experience conducting data mining in the healthcare insurance industry, healthcare claim audits, administrative medical record reviews or other claims analysis related experience
Knowledge of CPT, HCPCS and ICD-10 coding, reimbursement and claims processing policies
Strong analytical and qualitative skills as well as problem solving skills with the ability to look for root causes and implement workable solutions
Ability to interpret and apply law and regulations as it relates to fraud and fraud investigations
Ability to multi-task, establish priorities and work independently and collaboratively to achieve audit objectives
Proficiency in Microsoft Office applications (Word, Excel, PowerPoint and Access)
Excellent Customer service skills with the ability to interact professionally and effectively with providers, clients, and internal stakeholders from all departments
Ability to travel within Massachusetts and be on-site as needed for audits

Additional Information:

Preferred Qualifications:

Prefer individual possessing any of the following certifications or licensure: CPC or CPMA
Knowledge of state and federal regulations as they apply to public assistance programs

#LI-AC1

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Refine Your Search

auditor jobs in worcester, ma

Medical Program Auditor/ Analyst

Medical Billing Code Auditor- Healthcare Internal Audit - Hybrid work schedule

Senior Audit Specialist, Trade Compliance

Accountant I, Student Accounts (OneCard) - Worcester State University

Senior Internal Auditor

Accounting Manager

Accountant

Sr. Internal Audit Manager

Senior Accountant II

Staff / Project Accountant

Senior Accountant/Auditor

Auditor

Manager, Accounting & SEC Reporting

Staff Accountant

Outsourced Accounting Manager - Life Science

Controller

Accountant Analyst

Home Energy Auditor

Account Manager - IPM Auditing Exp Req

Audit & Assurance Manager

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