Remote Medicaid Audit & Compliance Specialist

Integrity Management Services, Inc.; États-Unis; À distance; USD 55 000 - 75 000; Plein temps

Avantages offerts par ce poste

Vacation and sick leave

Paid holidays

Health insurance

Dental insurance

Vision insurance

Short- and long-term disability

Life insurance

401(K) retirement plan

Educational benefits

Résumé du poste

Integrity Management Services, Inc. is seeking a Medicaid Auditor to support audits of managed care plans and providers, identifying fraud, waste and abuse and reporting findings.

You will apply data analysis, review medical records, and coordinate with federal/state agencies to ensure compliance with program requirements. Join a women-owned, small business with a strong commitment to professional development and flexible work.

Qualifications

• Bachelor’s Degree in finance, accounting or related field.
• 5-7 years of related experience in finance, accounting, or auditing.
• Intermediate knowledge of internal audit policies and operating principles.
• Experience auditing Medicare/Medicaid and other government programs (CMS, HRSA, OIG, DOE, Dept. of Commerce).
• Knowledge of Generally Accepted Government Auditing Standards (GAGAS).
• Strong data analysis skills.
• Knowledge of medical terminology, ICD-9-CM, ICD-10-CM HCPCS level II and CPT codes.
• Proficiency in Microsoft Word and Excel.

Responsabilités

• Perform audits of Medicaid Managed Care Plans and providers to identify fraud, waste, and abuse.
• Prepare and present findings to leadership, external agencies, and government partners.
• Calculate improper payments and issue findings with recommendations.
• Communicate with federal/state agencies regarding regulatory compliance and recovery.
• Maintain case development and documentation in appropriate tools and databases.
• Attend on-site audits to retrieve medical records and conduct conferences.
• Ensure audits conform to applicable regulations and GAAS standards.

Connaissances

Data analysis

Auditing

Medical terminology

MS Office

Communication

Formation

Bachelor’s Degree in finance, accounting or related field

Outils

Microsoft Word

Microsoft Excel

Description du poste

Integrity Management Services, Inc. is seeking a Medicaid Auditor to support audits of managed care plans and providers, identifying fraud, waste and abuse and reporting findings.

You will apply data analysis, review medical records, and coordinate with federal/state agencies to ensure compliance with program requirements. Join a women-owned, small business with a strong commitment to professional development and flexible work.