Medicaid Integrity Auditor

Are you a detail-oriented professional looking for a challenging role in healthcare? Do you have experience in data mining and analysis? We are seeking a skilled Medicaid Integrity Auditor to join our team at the University of Massachusetts Medical School.

As a Medicaid Integrity Auditor, you will be responsible for reviewing and analyzing claims data to identify errors and irregularities. You will also be responsible for investigating potential FWA and developing effective strategies to prevent future incidents.

This position requires a strong analytical mindset, excellent problem-solving skills, and the ability to work effectively under pressure. You will need to:

• Review and Analyze Claims Data: Review and analyze claims data to identify errors and irregularities.
• Investigate Potential FWA: Investigate potential FWA and develop effective strategies to prevent future incidents.
• Develop Recommendations: Develop recommendations for process improvements and system changes to prevent FWA.

To be successful in this role, you will need:

• A Bachelor's degree in Business Administration, Finance, Public Health, or related field; or equivalent years of experience.
• 5-7 years of related experience in fraud examination, healthcare, business, finance, or related field; with at least 2 years of experience conducting data mining in the healthcare insurance industry and claims-related experience.
• Knowledge of coding, reimbursement, and claims processing policies.
• Knowledge of the principles and practices of medical auditing.

Benefits include:

• Competitive Salary: Up to $110,000 per year, based on experience and location.
• Opportunities for Advancement: As a key member of our team, you will have opportunities to grow and advance your career in a dynamic and supportive environment.
• Collaborative Work Environment: Join a team of dedicated professionals who are passionate about making a difference in the lives of others.