Medicaid Fraud Auditor

🔥 0 minutes ago

🇺🇸 United States – 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.

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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 for compliance with federal and state Medicaid requirements • Recover over-payments for non-compliance • Research and 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 • 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 • Work independently or as part of a team and provide progress reports and audit-status updates • Present issues of concern supported by data and cite regulatory violations • Compose correspondence, reports, and referral summary letters • Ensure projects are timely, complete, and accurate • Participate in meetings and attend training

🎯 Requirements

• 2 years with BS/BA or 6 years with a high school 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 preferred • Intermediate audit/investigative skills preferred • Project management skills preferred • Knowledge of the healthcare industry and medical coding concepts and/or experience analyzing healthcare claims data preferred

🏖️ Benefits

• Telework available from any state in the US • Employees may be eligible for overtime • Employees may be eligible for shift differential • Employees may be eligible for a discretionary bonus • Equal opportunity employment, including disability and protected veterans