Unfortunately, this job posting is expired.
Don't worry, we can still help! Below, please find related information to help you with your job search.
Don't worry, we can still help! Below, please find related information to help you with your job search.
Related keywords
Some similar recruitments
Night Auditor Jobs
Recruited by Drury Hotels 8 months ago
Address , Chesterfield, 63017
$19 an hour
Night Auditor - $18/Hr
Recruited by Wild Dunes Resort 9 months ago
Address , Isle Of Palms, 29451
$18 an hour
Director-Managed Care Jobs
Recruited by Mercy 9 months ago
Address , Chesterfield, 63017
Full Service Hotel Night Auditor - Part Time
Recruited by Hotel Indigo - Vancouver Dwnt. 9 months ago
Address , Vancouver, 98660
Manager-Managed Care Jobs
Recruited by Mercy 9 months ago
Address , Chesterfield, 63017
Night Auditor Jobs
Recruited by Courtyard Potomac Mills 9 months ago
Address , Woodbridge, 22192, Va
Hotel Night Auditor | Part-Time
Recruited by Omni Hotels & Resorts 9 months ago
Address Richmond, VA, United States
Managed Care Coordinator Jobs
Recruited by Elevance Health 10 months ago
Address Richmond, VA, United States
Managed Care Coordinator-(Foster Care)
Recruited by Elevance Health 10 months ago
Address Alexandria, VA, United States
Full-Time Overnight Direct Care Associate - Icf ($34,611 Annually/$16.64 Hourly+ Shift Differential)
Recruited by Hampton-Newport News Community Services Board 11 months ago
Address , Hampton, 23666, Va
$16.64 an hour
Managed Care Coordinator - Lpn, Lsw, Lcsw, Or Lpc
Recruited by Elevance Health 1 year ago
Address , Norfolk, 23502, Va
Managed Care Specialist Bilingual
Recruited by Saint Peter's Healthcare System 1 year ago
Address , New Brunswick, 08901, Nj
Auditor, Medicaid Managed Care (Full-Time, Remote)
Company | Integrity Management Services, Inc. |
Address | Alexandria, VA, United States |
Employment type | FULL_TIME |
Salary | |
Category | Technology, Information and Internet |
Expires | 2023-09-03 |
Posted at | 9 months ago |
About Us
- Applied company policies and procedures in relation to complex investigations
- Managed large/varied case loads
- Reviewed financial records and advise or assist in the investigation of alleged fraud
- Bachelor’s degree in finance, accounting, or related field preferred
- Used Unified Case Management (UCM) and One PI Business Objects
- Intermediate knowledge of internal audit policies and operating principles
- Intermediate understanding of Medicaid managed care
- Reviewed medical claims and developing fraud cases
- Knowledge of the healthcare industry and medical coding concepts (CPT, ICD-9 / 10, DRGs) and/or experience analyzing health care claims data
- Typically 2+ years of related experience in finance, accounting, or auditing
- Sufficient writing skills to write a report that clearly identifies any fraud discovered, is easily comprehended, is complete, is thorough, and is accurate and supported by sufficient documentation
- Experience with statistical sampling and/or advanced statistical training
- Medicaid managed care work experience
- CPA, CFE, and/or AHFI certification is a plus
- Maintenance of audit notes and preparation of a written report summarizing the conclusions reached during the audit
- Ensure GAGAS standards are applied to each applicable audit to identify fraud, waste or abuse
- Conduct research on relevant State regulatory support for specific State’s and provider types
- Examination of all records, accounts, controls, medical billing and fiscal procedures of a Medicaid service provider
- Use of audit techniques and procedures to verify the appropriateness of the service provider charges for Medicaid eligible clients/services
- Preparation of exhibits such as analyses, graphs, reports, etc., intended to enhance and clarify any audit, which may be complex and hard to understand
- Understand and maintain the ability to apply regulatory support to the audit findings including ensuring that the citation works for the Provider type being audited
- Occasionally go into the field to collect, evaluate, and analyze evidence during an ongoing investigation
- Review all applicable State policies and regulations associated to each specific audit assignment or algorithm prior to performing audit
- Occasionally be required to assist in an ongoing investigation by conducting field interviews with investigators of providers and/or beneficiaries or patients witnesses
- Perform licensing and exclusion reviews on providers and work with the medical staff to ensure services reimbursed meet regulatory requirements
- Attend on-site audits to retrieve medical records and conduct provider entrance/exit conference
-
Systems Analyst - Excel, Xml, Sql, Scripting
By CyberCoders At Salt Lake City, UT, United States 7 months ago
-
(Senior) Finance & Shared Services Manager
By Catholics For Choice At Washington, DC, United States 7 months ago
-
Paralegal - Probate Administration
By CyberCoders At Miami, FL, United States 7 months ago
-
Account Executive - Automotive Software
By ECW Search At United States 7 months ago
-
Construction Project Coordinator Jobs
By CyberCoders At River Falls, WI, United States 7 months ago