Auditor - Medicaid Jobs

SafeGuard Services (SGS), a subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse.

Since 1999, SGS has prevented nearly $10 billion in inappropriate payments, consisting of more than $6.1 billion in proactively Prevented Dollars (including Savings from Revocations) and nearly $3.9 billion in Recovered Overpayment Dollars. Our experience with fraud and abuse analytics has resulted in the referral of thousands of cases to law enforcement and resulted in successful criminal and civil prosecution and civil monetary penalties.

We are seeking an Auditor to join our team.

• As part of an audit, the auditor will need to prepare correspondence; be objective and accurate and communicate with others with tact.
• Audits Medicaid healthcare providers, claims submissions and performs ad-hoc focused audits.
• Auditors are expected to research and understand the relevant issues being audited; and detect or verify suspected violations; obtain information and evidence by observation, record examination, and interviews.
• An auditor handles multiple caseload assignments concurrently; organizes and analyzes complex evidentiary patterns; and interviews.
• Develops an understanding of the function to be audited and uses business knowledge, analytical skills and experience in identifying findings and improvements.
• An auditor uses good judgment and may work independently with minimum supervision and direction.
• Auditors will be required to complete complex audit reports that apply federal or state laws, regulations or rules to the program(s) affected by the behavior being audited.
• The auditor also may work as part of a team as there may be times when the auditor needs to work with state and/or federal investigators and other personnel.
• The auditor will be working with health privacy information, they also must maintain confidentiality and understand all the laws, rules and regulations concerning health privacy.
• Identifies inherent and residual risks and conducts risk-based audits.

Telework available from: Central or Eastern Time Zone

• Strong research and analytical skills.
• Must have intermediate knowledge of internal audit policies and operating
• Must have intermediate knowledge of internal audit policies and operating principles.
• Intermediate risk assessment and scoping skills.
• BS 5-7 Years, MS 3-5, PhD 0-2.
• Must have intermediate understanding of Medicaid or healthcare auditing and their revenue cycles.
• Strong familiarity with Microsoft Office tools, including intermediate to advanced knowledge of Excel.
• Must have 2+ years of related experience in finance, accounting or audit.

Preferred Qualifications:

• Degree in finance, accounting or related field preferred.
• Basic project management skills.
• Intermediate financial and business acumen.