Remote Medicaid Auditor and Investigations Specialist

Integrity Management Services, Inc.; Alexandria (VA); Remote; USD 55,000 - 75,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

401(K) retirement plan

Educational benefits

Job summary

Integrity Management Services, Inc. is seeking a Medicaid Auditor to perform audits of Medicaid Managed Care Plans and providers, identify fraud, waste, and abuse, and report findings with recommendations.

The role includes on-site and remote work, relevant documentation, and interaction with federal/state agencies. Applicants should have a Bachelor’s in finance or accounting and 5–7 years of related experience, with strong data analysis and knowledge of Medicare/Medicaid programs.

Qualifications

• Bachelor’s Degree in finance, accounting or related field.
• 5-7 years of related experience in finance, accounting, or auditing.
• Knowledge of GAO/GAGAS standards.
• Experience auditing Medicare/Medicaid and government programs.
• Strong data analysis and investigative skills.
• Proficiency in MS Office.

Responsibilities

• Perform audits of Medicaid Managed Care Plans and providers.
• Identify fraud, waste and abuse; report findings and recommendations.
• Prepare and submit medical record requests.
• Conduct desktop and onsite audits.
• Ensure compliance with GAGAS standards.
• Prepare written audit reports for leadership and agencies.

Skills

Data analysis

Auditing

Communication

Teamwork

Attention to deadlines

Education

Bachelor’s Degree in finance, accounting or related field

Tools

Microsoft Office

Medicaid/Medicare knowledge

Job description

Integrity Management Services, Inc. is seeking a Medicaid Auditor to perform audits of Medicaid Managed Care Plans and providers, identify fraud, waste, and abuse, and report findings with recommendations.

The role includes on-site and remote work, relevant documentation, and interaction with federal/state agencies. Applicants should have a Bachelor’s in finance or accounting and 5–7 years of related experience, with strong data analysis and knowledge of Medicare/Medicaid programs.