Remote Medicaid Program Integrity Auditor

Peraton; United States; Remote; USD 66,000 - 106,000; Full time

Job summary

Peraton seeks a Medicaid Fraud Auditor to join SafeGuard Services (SGS). The role focuses on researching Medicaid requirements, developing audit procedures, and evaluating claims to identify overpayments and noncompliance.

The successful candidate will conduct audits across various Medicaid provider types, document findings, and prepare reports. Remote position requiring residency in the Northeast United States and US citizenship.

Qualifications

• Bachelor's degree in accounting, finance, business, healthcare administration, public health, health science, law, or a related field.
• MS/MA in a related field preferred; equivalent combination of education and experience will be considered.
• Experience conducting Medicaid, Medicare, healthcare compliance audits.
• Ability to plan, conduct, document, and complete audits independently.
• Strong ability to research and interpret laws and apply them to audit findings.
• Experience analyzing healthcare claims, billing records, and supporting documents.
• Strong written communication and analytical skills.

Responsibilities

• Conduct Medicaid compliance, payment, provider, and focused audits across provider types.
• Independently plan, develop procedures, test, analyze, and finalize audit findings.
• Research federal and state Medicaid statutes, regulations, and policies.
• Develop audit testing procedures addressing identified risks.
• Document evidence, conclusions, and financial impact in audit workpapers.

Skills

Auditing

Analytical thinking

Research skills

Communication skills

Education

BS/BA in accounting, finance, business, healthcare administration, public health, health science, law, or related field

MS/MA in a related field

Tools

Microsoft Excel

Microsoft Word

PowerPoint

Job description

Peraton seeks a Medicaid Fraud Auditor to join SafeGuard Services (SGS). The role focuses on researching Medicaid requirements, developing audit procedures, and evaluating claims to identify overpayments and noncompliance.

The successful candidate will conduct audits across various Medicaid provider types, document findings, and prepare reports. Remote position requiring residency in the Northeast United States and US citizenship.