Top 708 Medicaid auditor Jobs

Investigative Auditor
Wits Solutions Inc —Albany, NY
- $68,280.34 - $85,000.00 a year
- Full-time
- CPA
- Mid-level
- 3 years
Quick Apply
12h
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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SME - Medicaid Program Integrity and Claims Audits
BerryDunn —Remote
- $120,000 - $140,000 a year
- Full-time
- Bachelor of Science
- Research
- Mid-level
- Dental insurance
Corporate Compliance Clinical Auditor
Majestic Care —Westfield, IN
- Full-time
- Microsoft Excel
- RN License
- HIPAA
Quick Apply
12d
Auditor/Investigator II
Qlarant —Remote
- $56,055 - $83,665 a year
- Full-time
- Remote
- Mid-level
- Analysis skills
- Bachelor's degree
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Revenue Cycle Reimbursement Auditor
Titan Healthcare Management Solutions —Remote
- $20 - $25 an hour
- Full-time
- Remote
- Microsoft Excel
- Customer service
- Research
- Work from home
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Auditor, Risk Adjustment
Oscar Health —Atlanta, GA
- $82,717 - $108,566 a year
- Remote
- Mid-level
- Bachelor's degree
- Travel
- Paid parental leave
- Paid holidays
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Claims Auditor- Remote
American Health Plans —Franklin, TN
- Remote
- Mid-level
- 2 years
- Paid holidays
- Disability insurance
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Quality Auditor - Enrollment (Health Plan)
SCAN Health Plan —Lakewood, CA
- $25.38 - $36.76 an hour
- Full-time
- Remote
- Background check
- Microsoft Excel
- Microsoft Outlook
- Wellness program
- Paid holidays
Quick Apply
8d
Medical Coding Auditor
Xtensys Connected Health Solutions —Remote
- $67,000 - $76,000 a year
- Full-time
- Remote
- Mid-level
- 3 years
- High school diploma or GED
Senior Auditor - Medicaid Audit Division
State of North Carolina - Office of the State Auditor —Wake County, NC
- $90,000 - $100,000 a year
- Online Application
- 3 years
- Bachelor's degree
- Accounting
- Health insurance
- Paid time off
Associate Auditor
Health & Human Services Comm —Austin, TX
- $4,523.16 - $5,500.00 a month
- Multiple hires
- CPA
- Mid-level
- Office
- Health insurance
- Opportunities for advancement
Quick Apply
Physician Coding Auditor
MedKoder —Remote
- Full-time
- Remote
- Google Workspace
- Anatomy knowledge
- Microsoft Excel
- Profit sharing
- Continuing education credits
Quick Apply
Compliance Auditor
PRECISION HEALTHCARE SPECIALISTS LLC —Fort Myers, FL
- Remote
- Mid-level
- 3 years
- LPN
Quick Apply
Medical Coding Auditor
Humana —Remote
- $59,300 - $80,900 a year
- 8 hour shift
- Remote
- Microsoft Excel
- HIPAA
- Mid-level
- Paid parental leave
- Paid holidays
Clinical Review QC Auditor
CorVel Corporation —Fort Worth, TX
- $68,566 - $104,841 a year
- Full-time
- Remote
- LVN
- RN License
- Computer literacy
- Health savings account
- Disability insurance
Quick Apply
CDI Clinical Performance Auditor
Waystar —Remote
- Full-time
- Nursing
- 5 years
- Bachelor's degree
- Paid parental leave
- Paid holidays
Senior Internal Auditor
Harris Health —Houston, TX
- $92,800 - $116,000 a year
- Full-time
- Remote
- CPA
- 5 years
- Finance
- Health insurance
- Dental insurance
Internal Auditor II (Full-time Remote, North Carolina Based)
Alliance Health —Morrisville, NC
- $89,404 - $113,990 a year
- Full-time
- Remote
- Microsoft Excel
- CPA
- 3 years
- Disability insurance
- Health insurance
Zero Balance Auditor
EnableComp —Remote
- Full-time
- Remote
- Microsoft Outlook
- Customer service
- Computer literacy
Quick Apply
1d

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Investigative Auditor

Wits Solutions Inc -
Albany, NY

Quick Apply

Job Details

Full-time
$68,280.34 - $85,000.00 a year
12 hours ago

Qualifications

Healthcare claims management
Spreadsheets
Bachelor's degree
Accounting
Forensic accounting
Productivity software
Accounting

Full Job Description

Job Description:

Education/Certifications Mandatory:

Bachelor’s degree or higher in accounting, finance, economics, statistics, data analytics, healthcare administration, or related field.

Work Experience Mandatory:

Minimum three (3) years of professional experience involving accounting, auditing, healthcare claims analysis, forensic accounting, financial investigations, statistical analysis, or related analytical work.
Experience shall specifically address the candidate’s qualifications and work history relevant to the areas identified in Roles and Responsibilities Section.
Proficient in Microsoft Office applications, including Excel, Word, PowerPoint, and Access. U.S. Citizenship and ability to obtain adjudication for the requisite background investigation.
Experience and expertise in performing the requisite services in Roles and Responsibilities Section.

Education/Certifications Nice To Have:

Certified Public Accountant (CPA) Certification
Certified Fraud Examiner (CFE) Certification

Work Experience Nice To Have:

USAO Experience

Roles And Responsibilities:

Assist AUSAs and investigative agencies in conducting complex financial, statistical, healthcare, and forensic accounting analyses in support of civil fraud investigations and litigation.
Analyze and audit financial transactions, accounting systems, healthcare claims, reimbursement data, procurement records, grant expenditures, and related financial records.
Conduct healthcare claims analysis involving Medicare, Medicaid, TRICARE, VA, and other federally funded healthcare programs.
Assist with statistical sampling analyses and related methodologies, including familiarity with RAT-STATS or comparable statistical sampling tools.
Conduct damages analyses involving the False Claims Act, including calculations of damages, penalties, restitution-related figures, and related financial exposure.
Conduct asset tracing and ability-to-pay analyses to assist the Government in evaluating settlement positions, financial recoverability, and collection-related considerations.
Analyze large financial or healthcare-related datasets and organize financial and documentary evidence using industry-standard analytical and visualization tools.
Assist with financial tracing involving individuals, corporate entities, healthcare providers, contractors, grant recipients, and other entities.
Perform forensic accounting analyses involving incomplete, inconsistent, voluminous, or electronically stored financial records.
Review and analyze banking records, tax records, healthcare billing records, claims submissions, contracts, invoices, procurement materials, grant documentation, correspondence, and other documentary evidence.
Prepare concise and accurate audit reports, schedules, spreadsheets, charts, summaries, timelines, visualizations, and other analytical materials for use in investigations, settlement negotiations, motions practice, depositions, hearings, and trial.
Assist with interviews of witnesses, relators, subjects, healthcare providers, business representatives, law enforcement personnel, and other individuals relevant to ACE investigations.
Assist AUSAs, USAO support staff, and investigative agencies with deposition preparation, trial preparation, exhibit preparation, and related litigation-support activities.
Attend meetings, interviews, depositions, hearings, and trials as requested by the Government.
Assist in preparing declarations, affidavits, summaries, and related evidentiary materials.
Utilize electronic databases and publicly available sources to identify assets, financial information, and other relevant evidence.
Assist with organizing, indexing, securing, and managing documentary and electronic evidence. Prepare interim and final reports throughout investigations and litigation.
Assist in developing technical guidance and analytical approaches related to auditing, healthcare claims analysis, statistical sampling, forensic accounting, and financial investigations.
Work collaboratively with AUSAs, federal agents, agency personnel, and support staff to identify potential statutory and regulatory violations.
Utilize industry-standard financial, auditing, analytical, statistical, or visualization software tools.
Other related duties as assigned and within scope

Pay: $68,280.34 - $85,000.00 per year

Work Location: In person

Quick Apply

Refine Your Search

medicaid auditor jobs

Investigative Auditor

Compliance Billing Auditor/Investigator

SME - Medicaid Program Integrity and Claims Audits

Corporate Compliance Clinical Auditor

Auditor/Investigator II

Revenue Cycle Reimbursement Auditor

Auditor, Risk Adjustment

Claims Auditor- Remote

Quality Auditor - Enrollment (Health Plan)

Medical Coding Auditor

Senior Auditor - Medicaid Audit Division

Associate Auditor

Physician Coding Auditor

Compliance Auditor

Medical Coding Auditor

Clinical Review QC Auditor

CDI Clinical Performance Auditor

Senior Internal Auditor

Internal Auditor II (Full-time Remote, North Carolina Based)

Zero Balance Auditor

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