Remote Medicaid Fraud Auditor & Compliance Analyst

Peraton; Reston (VA); Remote; USD 66,000 - 106,000; Full time

Job summary

Peraton's SafeGuard Services seeks a Medicaid Fraud Auditor to join our team. You will research federal/state Medicaid requirements, develop audit procedures, analyze claims, identify potential overpayments, and clearly communicate audit conclusions.

The role emphasizes independent judgment, meticulous documentation, data analysis, and professional reporting. This is a remote position; candidates must reside within the Northeast jurisdiction.

Qualifications

• Bachelor's degree in accounting, finance, business, healthcare administration, public health, health science, law, or related field.
• Experience conducting Medicaid, Medicare, healthcare, compliance, financial, internal, or program integrity audits.
• Ability to plan, conduct, document, and complete audits or complex reviews independently.
• Ability to research and interpret laws, regulations, policies, and apply to audit findings.
• Strong written communication and documentation skills.

Responsibilities

• Conduct Medicaid compliance, payment, provider, and focused audits across diverse provider types.
• Plan and perform audits from development to testing and reporting.
• Research federal/state statutes, Medicaid manuals, policies, and guidelines.
• Develop audit testing procedures addressing identified risks and requirements.
• Analyze claims, payment data, documentation, and records to identify noncompliance.
• Prepare audit findings with applicable requirements, evidence, and financial impact.

Skills

Medicaid audits

Data analysis

Policy interpretation

Excel

Communication

Documentation

Independent judgment

Education

Bachelor's degree in accounting/finance/healthcare

Tools

Excel

Word

PowerPoint

Job description

Peraton's SafeGuard Services seeks a Medicaid Fraud Auditor to join our team. You will research federal/state Medicaid requirements, develop audit procedures, analyze claims, identify potential overpayments, and clearly communicate audit conclusions.

The role emphasizes independent judgment, meticulous documentation, data analysis, and professional reporting. This is a remote position; candidates must reside within the Northeast jurisdiction.