Compliance Auditor

Job Title:   Compliance Auditor

Are you an experienced Compliance Auditor looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions – this is the position for you!

Position Summary:• As the Compliance Auditor, you would be responsible for monitoring and auditing both Medicare and Medicaid products to ensure both internal and external performance and regulatory requirements are in compliance.

Hours for this Position:  Monday-Friday (40 hours/week)Advantages of this Opportunity:

• Competitive salary, negotiable based on experience

• Benefits offered, Medical, Dental, and Vision

• Fun and positive work environment

• Weekly deposit options

More Insight of Daily Responsibilities: 

• Collaborates with Care Management leadership on developing audit tools and audit project plans

• Ensures audit and monitoring timelines are met

• Provides support to the communications process which includes provider and member adverse notifications

• Provides support for the adverse determination process which includes ensuring notification meets regulatory/contractual requirements for content and timeliness

• Produces adverse determination information in support of an audit

• Assists management in developing project plans to ensure ongoing monitoring and oversight of utilization management functions

• Assists management with the collection of data and performs audits of utilization management functional areas