Remote opportunity at
Integrity Management Services, Inc.Medicaid Auditor (Full-time, Remote)
Integrity Management Services, Inc. (IntegrityM) is an award-winning, women-owned small business that assists commercial and government clients with compliance, program integrity, and the prevention of fraud,…
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About This Role
Integrity Management Services, Inc. (IntegrityM) is an award-winning, women-owned small business that assists commercial and government clients with compliance, program integrity, and the prevention of fraud, waste, and abuse. The organization utilizes data analytics, technology solutions, medical reviews, audits, and investigations to achieve results. IntegrityM is hiring a full-time Medicaid Auditor to work remotely. This position centers on evaluating Medicaid Managed Care Plans and Providers to uncover potential improper payments,…
Job Description
Integrity Management Services, Inc. (IntegrityM) is an award-winning, women-owned small business that assists commercial and government clients with compliance, program integrity, and the prevention of fraud, waste, and abuse. The organization utilizes data analytics, technology solutions, medical reviews, audits, and investigations to achieve results.
IntegrityM is hiring a full-time Medicaid Auditor to work remotely. This position centers on evaluating Medicaid Managed Care Plans and Providers to uncover potential improper payments, fraud, waste, and abuse, while issuing actionable findings and recommendations. Audits may be financial or programmatic, taking the form of desk reviews or on-site evaluations depending on state and federal rules. Specific duties involve examining billing and medical records, conducting trend analysis, submitting medical record request letters, and drafting objective reports for leadership and government partners.
This role is ideal for professionals with a background in finance, accounting, or auditing who possess knowledge of government healthcare programs. Candidates must be able to operate independently and collaboratively within a team environment, meet deadlines, and maintain confidentiality.
Responsibilities
- Apply federal and state regulations along with healthcare industry standards
- Examine and calculate financial documents and provider cost reports
- Use data mining and trend analysis tools to spot anomalies in Medicaid billing
- Prepare and submit medical record request letters to providers
- Interpret and apply laws, regulations, policies, and procedures to audit findings
- Draft factual written reports for leadership, external agencies, and government partners
- Communicate with federal and state agencies regarding compliance and audit findings
- Attend assigned briefings and presentations
- Keep case development databases and investigative applications updated in a timely manner
Requirements
- Pass post-hire background screening checks
- Maintain wired or wireless internet access for remote work
- Possess a Bachelor's Degree in a related field
- Have two to five years of related experience in finance, accounting, or auditing
Qualifications
- Knowledge and experience auditing Medicare, Medicaid, and other government oversight programs
- Familiarity with government accounting principles and standards including GAGAS
- Investigative skills and data analysis capabilities
- Understanding of medical terminology, ICD-9-CM, ICD-10-CM, HCPCS level II, and CPT codes
- Experience reviewing claims for billing and medical coding requirements or developing fraud cases
- Proficiency in Microsoft Word and Excel
Core Skills
Benefits
- Vacation and sick leave
- Paid holidays
- Health, dental, and vision insurance
- Short- and long-term disability
- Life insurance
- Employee assistance plan
- 401(K) retirement plan
- Educational benefits
Frequently Asked Questions
Answers are based only on the employer’s listing; where it doesn’t say, neither do we.
Is this position remote?
Yes, this role is remote, and remote workers are required to have wired or wireless internet access.
What is the salary range for this role?
The annual salary range for U.S. remote locations is $55,000 to $75,000, though final pay may vary based on experience, location, and other job-related factors.
What education and experience are required?
Candidates must have a Bachelor's Degree in a related field and two to five years of related experience in finance, accounting, or auditing.
What type of employment is this?
This is a full-time regular position that is eligible for full-time employee benefits.
Sample Interview Questions
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