Remote Medicaid Auditor & Investigator

Peraton; Reston (VA); Remote; USD 51,000 - 82,000; Full time

Job summary

Peraton is seeking a Medicaid Auditor/Investigator to join SafeGuard Services (SGS), a Peraton subsidiary. The role focuses on conducting audits and data analyses to detect fraud, waste, and abuse in Medicaid programs.

You will perform interviews, document findings, and present data-driven conclusions while ensuring compliance with federal and state requirements. The position is remote, requiring residency within the Northeast Jurisdiction (including VA).

Qualifications

• 2 years with BS/BA or 6 years with a HS diploma.
• Experience in accounting or related 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.

Responsibilities

• Conduct audits and reviews of Medicaid programs to ensure compliance and recover over-payments.
• Apply intermediate subject matter knowledge to solve common issues; work on moderately complex problems.
• Organize and document case files; provide progress reports and updates on audit status.
• Identify compliance exceptions and make recommendations for improvements.
• Present issues of concern with data-backed regulatory violations and potential fraud schemes.
• Compose correspondence, reports and referral letters; work under supervision within a team.

Skills

Research and analytical skills

MS Excel

Microsoft Office

Education

2 years with BS/BA or 6 years with HS diploma

Tools

Excel

Microsoft Office

Job description

Peraton is seeking a Medicaid Auditor/Investigator to join SafeGuard Services (SGS), a Peraton subsidiary. The role focuses on conducting audits and data analyses to detect fraud, waste, and abuse in Medicaid programs.

You will perform interviews, document findings, and present data-driven conclusions while ensuring compliance with federal and state requirements. The position is remote, requiring residency within the Northeast Jurisdiction (including VA).