Program Auditor

At UMass Med School, we are seeking a highly skilled Program Auditor to join our team. As a Program Auditor, you will play a crucial role in combating fraud, waste, and abuse (FWA) within the Medicaid program.

Key Responsibilities:

• Conduct desk and onsite reviews based on federal and state regulations.
• Perform data mining and claims analysis to identify potential cases of FWA.
• Develop reports of investigative findings and communicate with providers regarding issues such as regulatory compliance and audit findings.
• Identify and recommend policy, procedure, and system changes to enhance investigative outcomes and performance.

Requirements:

• Bachelor's degree in business administration, finance, or a related field.
• 6-8 years of related experience in the healthcare industry, business, accounting, or finance.
• Knowledge of the principles and practices of medical auditing.
• Strong analytical and problem-solving skills.

Preferred Qualifications:

• Master's degree in Business Administration or Public Health.
• Knowledge of coding, reimbursement, and claims processing policies.
• Advanced Microsoft Excel software skills.