Remote Medicaid Auditor - Fraud & Compliance Lead

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

Benefits offered by this job

Health insurance

401(K) retirement plan

Paid holidays

Vacation and sick leave

Professional development opportunities

Job summary

Integrity Management Services, Inc. in the United States seeks a Medicaid Auditor to perform and report on Medicaid Managed Care Plans and providers, identifying potential fraud, waste, and abuse.

Audits can be programmatic or financial, including desk reviews and onsite activities per federal/state regulations. The role involves preparing reports, communicating findings to leadership and government partners, and ensuring compliance with applicable laws, policies, and procedures while

Qualifications

• Bachelor’s degree in finance, accounting or related field required.
• 5–7 years of related experience in finance, accounting, or auditing.
• Knowledge of GAGAS, CMS/Medicaid auditing and government programs.
• Strong data analysis skills and proficiency with MS Office.

Responsibilities

• Comprehends and follows auditing plans and methodologies specific to contract requirements.
• Prioritizes workload and ensures adherence to task order policies.
• Examines data from provider cost reports to inform audit conclusions.
• Uses data mining and trend analysis to detect Medicaid billing anomalies.
• Prepare and submit medical record request letters to providers.
• Prepare factual written reports and present findings to leadership and agencies.

Skills

Data analysis

Auditing

Communication skills

Attention to detail

Teamwork

Education

Bachelor's Degree in finance, accounting or related field

Tools

Microsoft Word

Microsoft Excel

Job description

Integrity Management Services, Inc. in the United States seeks a Medicaid Auditor to perform and report on Medicaid Managed Care Plans and providers, identifying potential fraud, waste, and abuse.

Audits can be programmatic or financial, including desk reviews and onsite activities per federal/state regulations. The role involves preparing reports, communicating findings to leadership and government partners, and ensuring compliance with applicable laws, policies, and procedures while