Long-Term Care Auditor I
New
G
Gainwell TechnologiesMedicaid auditing
Source API remote eligibility restrictions: United States, Eastern or Central Time ZoneFull-TimeEntry
Salary not disclosed
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Job Details
- Required Skills
- Problem SolvingWritten communicationVerbal communication
Requirements
- College degree required.
- Demonstrate strong analytical and problem-solving skills.
- Work independently and manage competing deadlines and multiple initiatives simultaneously.
- Use strong organizational and time-management skills to meet or exceed revenue and audit targets.
- Communicate effectively in writing and verbally with internal teams and long-term care providers.
- Adapt to shifting priorities and follow direction as needed.
- Reside in an Eastern or Central Time Zone location.
- Have reliable broadband internet with a minimum of 24 Mbps download and 8 Mbps upload.
Responsibilities
- Interpret and apply federal and state Medicaid regulations, statutes, and policies related to long-term care.
- Analyze provider records across multiple accounting software systems to identify discrepancies.
- Identify improper payments, including those resulting from inaccurate payments, collections issues, and coordination of benefits.
- Serve as the primary liaison for assigned long-term care providers throughout the review process.
- Manage a caseload of 30 or more audits in various stages of completion.
- Prepare and deliver provider reports and maintain ongoing communication throughout the audit process.
- Provide regular status updates and reports to management.
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