Medicaid Fraud Auditor

🔥 1 hour 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

🟢 Junior

🟡 Mid-level

🔎 Auditor

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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 Medicaid programs for compliance with federal and state requirements • Recover over-payments resulting from non-compliance • Research and interpret laws and regulations • Perform data analysis and draw conclusions • Conduct compliance audits of varied Medicaid case types and audit claim submissions • Perform ad-hoc focused audits • Organize and analyze billing patterns • Conduct interviews and obtain statements from beneficiaries, recipients, and others • Identify findings, compliance exceptions, conflicts of interest, and improper payments • Organize case files and accurately document all steps taken • Provide progress reports and audit-status updates • Present data-verified concerns, regulatory violations, and fraud schemes • Compose correspondence, reports, and referral summary letters • Attend meetings and training • Ensure projects are timely, complete, and accurate

🎯 Requirements

• 2 years with BS/BA or 6 years with a high school diploma • Experience in accounting or a 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 • Intermediate to advanced knowledge of Microsoft Office tools, including 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 healthcare claims data preferred

🏖️ Benefits

• Employees may be eligible for overtime • Shift differential may be available • Discretionary bonus may be available