Special Investigations Auditor: Provider Compliance

Blue Cross & Blue Shield of Mississippi; Flowood (MS); On-site; USD 60,000 - 90,000; Full time

Job summary

A health insurance company in Flowood, Mississippi is seeking an Auditor for Special Investigations. The role involves conducting audits of Network Providers to ensure compliance, and to identify and address issues of fraud, waste, and abuse. The ideal candidate should have a Bachelor's degree in Business or a related health field, along with three years of audit experience, preferably in the healthcare industry. Strong communication and data analysis skills are essential. Comprehensive benefits provided.

Qualifications

• Three years of audit experience, preferably with Institutional providers.
• Healthcare experience preferred.
• Experience in data analysis and analytical reporting required.

Responsibilities

• Conduct comprehensive audits of Network Providers for compliance.
• Identify and remediate Provider fraud, waste, and abuse.
• Collaborate with Management and Provider Compliance team.

Skills

Data analysis

Oral communication

Written communication

Microsoft Office Suite

Education

Bachelor’s Degree in Business or health-related field

Job description

A health insurance company in Flowood, Mississippi is seeking an Auditor for Special Investigations. The role involves conducting audits of Network Providers to ensure compliance, and to identify and address issues of fraud, waste, and abuse. The ideal candidate should have a Bachelor's degree in Business or a related health field, along with three years of audit experience, preferably in the healthcare industry. Strong communication and data analysis skills are essential. Comprehensive benefits provided.