Remote Medicaid Auditor and Investigations Specialist
Integrity Management Services, Inc.
- Remote job
Integrity Management Services, Inc. is seeking a Medicaid Auditor to perform audits of Medicaid Managed Care Plans and providers, identify fraud, waste, and abuse, and report findings with recommendations. The role includes on-site and remote work, relevant documentation, and interaction with federal/state agencies. Applicants should have a Bachelor’s in finance or accounting and 5–7 years of related experience, with strong data analysis and knowledge of Medicare/Medicaid programs. #J-18808-Ljbffr Integrity Management Services, Inc.
- ...Peraton is seeking a Medicaid Auditor/Investigator to join SafeGuard Services in a remote capacity. You will conduct audits of Medicaid programs to ensure compliance with federal and state requirements and recover over-payments. Strong analytical skills and Excel proficiency...Remote work
- SafGuard Services (SGS), a Peraton subsidiary, is seeking a Medicaid Auditor/Investigator to perform audits and data analyses on various Medicaid programs from a remote location in the United States. The role emphasizes independent judgment, adherence to regulations, and...Remote job
- ...Knowledge of internal audit/investigative policies and operating principles... .... Understanding of Medicare/Medicaid or healthcare auditing.... ...are looking to add a Medicaid Auditor/Investigator to our SGS team... ...his business acumen. This is a remote position. #J-18808-Ljbffr PeratonRemote workWork at office
- ...Partnerships LLC is seeking a Fraud Audit & Investigations Analyst to lead investigations into fraud, waste, and abuse within Medicaid programs. You will audit case files,... ...strong documentation skills and ability to work remotely with occasional travel. #J-18808-LjbffrRemote work
- ...SafeGuard Services (SGS), a subsidiary of Peraton, is seeking a Medicaid Fraud Auditor to join the SGS team. The role focuses on researching laws, conducting compliance audits across Medicaid cases, and identifying improper payments. Telework is available from any state...Remote work
$90.58k - $114.59k
Position InformationNY HELPS: No55-b/c Eligible: NoAgency: Medicaid Inspector General, NYS Office of the Title: Investigative Specialist 2 MedicaidOccupational Category: No PreferenceSalary Grade: 23Bargaining Unit: PS&T - Professional, Scientific, and Technical (PEF)Salary...Remote workPermanent employmentFull timeWork experience placementInternshipWork at officeVisa sponsorship$55k - $75k
...analytics, technology solutions, audit, investigation, and medical review. At IntegrityM, we... ...company feel! In this role, the Medicaid Auditor will be responsible for performing and... ...hire background screening checks. For remote work, required to have wired and/or wireless...Remote workFull timeContract workTemporary workFor contractorsWork at officeLocal areaFlexible hours- ...Peraton is seeking a Medicaid Fraud Auditor for its SafeGuard Services (SGS) team to conduct audits of Medicaid programs, ensure compliance with... ...and knowledge of Medicaid auditing are essential. This remote role offers telework from any state in the US, with potential...Remote work
- ...The Investigative Specialist 2 Medicaid works for the NYS Office of the Medicaid Inspector General to investigate Medicaid fraud, waste, and abuse by providers. The role supervises investigative staff in regional offices, evaluates complaints, conducts complex investigations...Permanent employmentWork at office
- ...Services (SGS) a subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and... ...recover fraud, waste, and abuse. We are looking to add a Medicaid Fraud Auditor to our SGS team of talented professionals. Required...Remote workWork at office
- ...Solutions Organization LLC (SSO) is seeking a Licensed Professional Counselor to join our remote Healthcare Investigator team in Ohio. The role conducts investigations into Medicaid incidents, analyzes documentation, interviews involved parties, and ensures compliance...Remote workLocal areaWork from home
- ...The Agency for Health Care Administration seeks an Inspector Specialist to conduct investigations into fraud, abuse, and waste within the Florida Medicaid program. You will perform on-site visits, prepare investigative reports, and collaborate with multiple units to enforce...
- ...SafeGuard Services (SGS), a Peraton subsidiary, seeks a Medicaid Fraud Auditor to join our team. The role audits Medicaid programs for compliance and over-payment recovery, applying analytical skills and interviews to gather information. Candidates must reside within...Remote work
- ...Arizona Supreme Court is seeking an Investigator and Compliance Auditor – Specialist V to lead investigations of complaints against licensed professionals and conduct compliance audits across the state. You will manage cases from intake to disposition and present findings...Remote work
- ...CoventBridge Integrity Systems seeks an experienced Medicaid claims auditor with an active RN license to review claims for potential fraud.... ...coding knowledge to assess payment accuracy and document investigative findings. The role involves preparing detailed investigative...
- Gainwell Technologies is seeking an entry-level Long-Term Care Auditor I to support identification and recovery of Medicaid improper payments in long-term care. This remote role requires strong organization, attention to detail, and the ability to manage a caseload across...Remote jobFlexible hours
- ...Xcelerate Solutions is seeking Case Reviewers to join a remote government contracting team. You will review background investigation reports submitted by Field Investigators and Record Searchers to ensure accuracy, completeness, and timely submission. The role requires...Remote work
- ...0-03DaMar Staffing is seeking an experienced Quality Assurance Auditor with a coding background. The role focuses on reviewing medical... ...education and risk mitigation initiatives.Location is Phoenix, AZ or remote. Requirements include 5+ years of professional coding, 3+ years...Remote work
- ...Guided Care is seeking a part-time Licensing Specialist to manage licensing, Medicare, and Medicaid registrations with accurate, timely submissions. The role... ...Director of Licensing and requires independent work in a remote-capable setup within the United States. #J-18808-...Remote workPart time
- ...Alpine Intel is seeking investigators to conduct workers' compensation, liability, and multi-line insurance claim investigations, including... ...footage with timely updates. The Robison Group provides remote or in-classroom training; a college degree is preferred; applicants...Remote work
- ...The Office of the Special Commissioner of Investigation for the New York City School District (SCI) seeks an experienced Confidential Investigator to conduct confidential investigations into corruption, unethical conduct, and other misconduct within the NYC school system...Remote workWork at office
- ...Gainwell Technologies Wisconsin is seeking a Professional Field Representative to support Wisconsin Medicaid providers as a key liaison for education, issue resolution, and operational support. This role partners with providers and stakeholders to research and resolve...Remote work
$30 - $45 per hour
...consulting agency is seeking an Operations Specialist III for a contract opportunity in Long... ..., CA. This role requires expertise in Medicaid and Medi-Cal operations, along with experience... ...program metrics. This position is remote and offers a pay range of $30-$45 per hour...Remote workHourly payContract work$51k - $82k
...Services (SGS), a subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and... ...recover fraud, waste, and abuse. We are looking to add a Medicaid Fraud Auditor to our SGS team of talented professionals. What you'll do...Remote workContract workTemporary workWork at officeShift work- ...AuraOne, Inc. is seeking a remote Embodied Navigation Task Evaluator to review outputs, compare responses, and label issues using AuraOne's quality rubric. The role focuses on labeling edge cases, writing rationales, and contributing to retraining efforts. Responsibilities...Remote workFor contractors
- ...Humana Inc. seeks a Policy Governance Professional to manage the Medicaid Utilization Management Rates and Timeliness evaluation and reporting process across applicable markets, including both physical and behavioral health. You will coordinate schedules, validate...Remote work
- ...seeking a Community Relations Representative I to expand market reach in North Carolina. This remote role covers outreach, enrollment assistance, and education for Medicaid/Medicare products across the state. You will attend community events, build partnerships, conduct...Remote work
- ...dedicated, hardworking, analytical and results oriented. Candidates will be responsible for a wide range of duties related to the investigation and elimination of online e-commerce risk. The position relies on an analytical mind, detailed investigation and excellent...Remote workFixed term contractWeekend workDay shiftEarly shift
$63.3k - $114.3k
...Preparing documentation of findings and consulting with special investigation and the affordability of care area as needed. Coordinating... ...~ Current AAPC Medical Coding Certification #LI-MW2 #LI-Remote Are you being referred to one of our roles? If so, ask your...Remote workFull timeWork from home- ...Humana Inc. is seeking a Policy Governance Professional to manage end-to-end Medicaid Utilization Management (UM) Rates and Timeliness evaluation and reporting across markets. Reporting to the Policy Governance Lead, you will coordinate data validation, analyze trends...Remote work
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