Medicaid Auditor – Investigator

🔥 14 hours ago

🦌 Connecticut, Maine, +9 more states – Remote

🦌 Connecticut – Remote 🦞 Maine – Remote 🗻 New Hampshire – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote 🦀 Maryland – Remote 🍂 Massachusetts – Remote 🔔 Pennsylvania – Remote ⚓ Rhode Island – Remote 🍁 Vermont – Remote ⚔️ Virginia – Remote

💵 $51k - $82k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔎 Auditor

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Peraton

WebsiteLinkedInAll Job Openings

10,000+ employees

💼 Consulting

🏥 Healthcare

📦 Logistics

Consulting • Healthcare • Logistics

Peraton is a mission-focused enterprise that supports national security initiatives through advanced IT and cyber services. They provide capabilities in areas such as cyber defense, cloud operations, engineering, and intelligence. With a commitment to solving complex challenges, Peraton integrates data-driven technologies to ensure mission success for their military and government clients.

📋 Description

• Conduct audits and reviews of various Medicaid programs to ensure compliance with federal and state Medicaid program requirements and recover over-payments for non-compliance • Research, interpret laws and regulations, perform data analysis, and draw conclusions for projects • Conduct compliance audits of varied Medicaid case-types, audit claim submissions, and perform ad-hoc focused audits • Handle several assignments concurrently; organize and analyze billing patterns; conduct interviews and obtain statements from beneficiaries/recipients and others • Develop an understanding of the function to be audited and use business knowledge, analytical skills, and experience to identify findings and make recommendations for improvements • Identify compliance exceptions, conflicts of interest, and improper payments • Organize case files and accurately and thoroughly document all steps taken • Work independently or as part of a team, providing ongoing progress reports and updates on audit status • Present issues of concern verified through data, citing regulatory violations and proving schemes or scams to defraud the Government • Compose correspondence, reports, and referral summary letters • Work under general supervision as a member of a team delivering high-quality work • Ensure projects are timely, complete, and accurate • Actively participate in meetings and attend training to further business acumen

🎯 Requirements

• 2 years with BS/BA or 6 years with a HS diploma • Experience in accounting or closely related business field, law enforcement, health science or related field • Knowledge of internal audit/investigative policies and operating principles • Understanding of Medicare/Medicaid or healthcare auditing • Strong research and analytical skills • Strong familiarity with Microsoft Office tools, including intermediate to advanced knowledge of Excel • Must be a US Citizen • Intermediate financial and business acumen • Intermediate audit/investigative skills • Project management skills • Knowledge of the healthcare industry and medical coding concepts and/or experience analyzing health care claims data is preferred