Remote Medicaid Auditor - Fraud & Compliance Lead
Integrity Management Services
Integrity Management Services, Inc. in the United States seeks a Medicaid Auditor to perform and report on Medicaid Managed Care Plans and providers, identifying potential fraud, waste, and abuse. Audits can be programmatic or financial, including desk reviews and onsite activities per federal/state regulations. The role involves preparing reports, communicating findings to leadership and government partners, and ensuring compliance with applicable laws, policies, and procedures while
#J-18808-Ljbffr$55k - $75k
...government and commercial clients in compliance and program integrity... ...prevention and detection of fraud, waste and abuse in... ...feel! In this role, the Medicaid Auditor will be responsible for performing... ...background screening checks. For remote work, required to have wired...Remote workFraudFull timeContract workTemporary workFor contractorsWork at officeLocal areaFlexible hours- ...galaxy. As the world’s leading mission capability... ...referrals to recover fraud, waste, and abuse. We... ...are looking to add a Medicaid Auditor/Investigator to our SGS... ...Medicaid programs to ensure compliance with federal and state... ...acumen. This is a remote position. Experience...Remote workFraudContract workTemporary workWork at officeShift work
- ...POSITION SUMMARY: The Sr Compliance Auditor is responsible for... ...accommodation) ~ Leads and conducts... ...to safeguard against fraud, waste, and abuse.... ...managed care, Medicare, Medicaid, and workers’ compensation... ...equipment (in office or remote) ~ Communicate...Remote workFraudFull timeWork at officeLocal area
- ...focus include Medicare, Medicaid, commercial insurance, worker... ..., and clinical compliance. Marwood operates at the... ...outpatient Certified Coding Auditor to work in its New York office or remotely. Principal duties and responsibilities... ...regulations, applicable fraud statutes, and...Remote workFraudWork at officeLocal area
- ...Compliance Auditor The Compliance Auditor is responsible for... ...action plans to prevent fraud, abuse, and compliance... ...for Medicare & Medicaid Services regulations.... ...working in the office and remote/telework May involve... ...growing organization to lead the Company's efforts...Remote workFraudWork at officeLocal area
$51k - $82k
...galaxy. As the world’s leading mission capability... ...referrals to recover fraud, waste, and abuse.... ...are looking to add a Medicaid Auditor/Investigator to our SGS... ...Medicaid programs to ensure compliance with federal and state... ...acumen. This is a remote position....Remote workFraudFull timeContract workTemporary workWork at officeShift work- CoventBridge Integrity Systems is seeking a Medicaid Medical Review RN (Medical Reviewer III) for remote work with potential on-site audits in Grove City, OH. The... ...on clinical reviews of medical records during fraud investigations and applies Medicare/Medicaid guidelines...Remote jobFraud
- ...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
- ...Position performs and/or leads compliance related projects and... ...flexibility to work remote from home anywhere in... ...requirements of State Medicaid Programs, OIG and CMS... ...coordinates with external auditors. Assists Corporate... ...) preferred Certified Fraud Examiner (CFE) preferred...Remote workFraudFull timePart timeWork at officeWork from homeFlexible hours
- Integrity Management Services, Inc. is seeking a Medicaid Auditor to support audits of managed care plans and providers, identifying fraud, waste and abuse and reporting findings.... ...with federal/state agencies to ensure compliance with program requirements. Join a women-...Remote jobFraudFlexible hours
$86.8k - $198k
Internal Auditor, Lead The Opportunity: As an Internal Auditor, Lead,... ...financial, program-specific, and compliance audits. You will evaluate... ...Accountant (CPA), Certified Fraud Examiner (CFE), or Certified... ...cameras on during meetings. Remote : If this position is listed...Remote workFraudFull timeContract workPart timeLocal area- ...CoventBridge Integrity Systems is seeking a Medicaid Medical Review RN (Medical Reviewer III) to conduct clinical chart reviews for fraud investigations and program integrity... ...determine payment coverage. This position is remote, with occasional on-site audits in OH if needed...Remote workFraud
- ...Jackson Health System is seeking a Senior Auditor to lead internal audits, manage fieldwork, and communicate directly with hospital management. The role covers compliance, fraud investigations, and coordination with the Audit Manager. The ideal candidate has 5–7 years...FraudFull timeWeekday work
- ...Ensemble Health Partners is seeking a Senior Coding Compliance Auditor to lead detailed audits, develop the annual compliance workplan, and drive... ...leadership while partnering with service lines to reduce risk. This remote role requires travel to client sites up to 10% and requires...Remote work
- ...regular coding audits, and develop comprehensive educational materials to raise coding accuracy and regulatory compliance across facilities. In this remote role, you will collaborate with providers, operations, and IT to optimize EMR processes, streamline documentation...Remote work
- ...Internal Auditor The Internal Auditor conducts audits across the branch network and specialized areas to ensure compliance with company policies, procedures, and applicable state and federal... ...assets, detecting and preventing fraud, and supporting operational...Remote workFraudWork at office
- ...ISO Lead Auditor, Remote, India At Prescient Security, we are on a mission to simplify security and compliance. Our core values are: ~ Bring Order to Chaos ~ Be Accountable & See it Through ~1000% With You ~ Support & Collaborate ~ Think Outside the...Remote workFlexible hours
- ...Noridian Healthcare Solutions, LLC is seeking a Senior Provider Auditor to conduct CMS and other financial analyses, desk reviews, and... ...interact professionally with providers. The position supports remote work eligibility and requires at least 3 years of Medicare auditing...Remote work
$92.3k - $120k
...sitting at the intersection of Compliance, Payment Integrity, and Data... ...instances of healthcare fraud, waste and abuse (FWA). Come... ...against FWA! As a Medical Claims Auditor within our Special Investigations... .... Additionally, we embrace a remote-first culture that supports...Remote workFraudFull timeWork experience placementWork at officeFlexible hours- ...products (FBO and HYSA). This role sits at the nexus of product, compliance, fraud, support, and marketing, ensuring safe, scalable, and... ...operations, monitor KPIs, drive cross-functional alignment, and lead the roadmap for deposit products with a focus on delivering measurable...Remote workFraud
- ...Department of Gaming is seeking a detail-oriented Auditor 3 to perform audits of Tribal Gaming Operations and ensure compliance with tribal, State, and federal gaming... ...assists with special reviews, including financial and/or fraud audits. #J-18808-Ljbffr State of ArizonaRemote jobFraud
- ...: Other Workplace Type: Remote Standard Hours: Open Reference... ...activities to ensure compliance with SOX requirements. We... ...with process owners, external auditors, and project stakeholders to... ...activity, please contact fraud@eliassen.com . About Eliassen...Remote workFraudHourly payLocal area
$78k
...Shift: Day Workplace: Remote Career Area: Corporate... ...internal controls, consumer compliance, technology, operational risk... ...seeking an experienced Senior Auditor – Audit, Global Servicing in... ...support our Conduct, Internal Fraud, and Insider Risk team as needed...Remote workFraudFull timeWork at officeWorldwideShift work- ...Nurse (RN) to review and evaluate medical necessity, appropriateness, quality, and compliance of services rendered by providers. This role involves claims analysis, provider audits, fraud detection, and regulatory enforcement to ensure compliance with state and federal...Remote jobFraudWork at office
- Signature Performance, Inc. is seeking an Outpatient Coding Auditor for a remote nationwide role. You will conduct quality reviews, audits, and provide actionable feedback to improve coding accuracy and documentation quality across departments. Ideal candidates have 5+...Remote job
$50 - $60 per hour
...CURE Auto Insurance is a leading direct writer of auto... ...is seeking an Attorney Auditor to join our team. You’ll... ..., reasonableness and compliance with agreed upon fee structure... ..., and identity & fraud protection ~24/7 Employee... ...: Hybrid or fully remote in Princeton, NJ 08540...Remote workFraudHourly payPart timeWork at officeLocal areaWork visaFlexible hours- Judge Group, Inc. is seeking a Senior Principal GMP Compliance Auditor to lead independent GMP audits across pharmaceutical sites, laboratories,... ...strategic guidance. The position involves conducting on-site and remote audits, preparing detailed reports, and guiding cross-...Remote job
- ...seeking a highly motivated Senior Internal Auditor to join our Internal Audit team. Our... ...financial, complemented by operational, compliance, and special reviews. In this role, you... ...strategic initiatives and projects.Support fraud investigations, cost-improvement...Remote workFraudWork at office
- ...expertise with data analysis to assess medical necessity, detect unusual utilization, and ensure compliant benefits administration. Remote work options are available with state approvals. The position requires U.S. citizenship, RN or LPN licensure, and 3+ years of...Remote jobFraudFor contractors
$99k - $225k
...designing enterprise-scale STIG compliance solutions. This role is... ...trusted advisor and technical lead, helping clients move from fragmented... ...and protect against identity fraud. You are expected to be on... ...their cameras on during meetings.Remote: If this position is listed as...Remote workFraudFull timeContract workPart timeFor contractorsLocal area
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