Hotline: 678-408-1354

The Office of Inspector General is looking for a highly motivated individual to join our team as a Compliance Auditor . This is a high level multi-faceted position that will deal with assisting in the completion of all projects under performance improvement. Major duties and responsibilities include but are not limited to:

* Conduct Performance and provider audits for OIG Conduct external Audits in all aspects of OIG to ensure compliance and integrity (Analyze claims, encounter data, review medical records, conduct on-site visits, record interviews, produce high level reports, audit related correspondence, CAPs and follow-up performance reviews

* Assist in the Hospital Prospective Eligibility audit process.

* Assist in the review and tracking of Corporate Compliance Contract Deliverables for the Health Plans and RBHAs.

* Research Statutes and changes to Medicaid and Medicare and assist with compliance.

* Interact with Management at a high level, providing guidance when necessary.

* Able to write accurate and consistent audit reports, elaborate charts and present claims analysis and recommendations

* Analyze policy and contracts to ensure performance. Provide recommendations to process change and improvements.

Minimum Qualifications

* Knowledge of Research, communications and briefings, Government process, Data collection/metrics, Medical coding, Reconciling records and records management and Program Management.

* Ability to analyze, interpret and communicate data, Communicate effectively both verbally and in writing, Conduct performance audits, Understanding the process and administrative function, Provide strong research skills, Perform accurate and timely work with minimal supervision.

* Ability to interpret and explain financial, operational and administrative information, Take initiative. Work in a team environment, plan, summarize and analyze large amount of complex information and data and to present information in a clear and concise fashion.

* Skilled in Mathematics, Financial Reconciliation Processes, Research and analysis, and Problem Solving.

Preferred Qualifications

* Analytical Background, Strong computer skills, Government background or military service, Understanding the importance of data collections and metric and can gather intelligence information

* Prefer a college degree in a related field and/or Certification in Project Management

Contact Us

Eltas EnterPrises Inc.
3978 Windgrove Crossing
Suite 200A
Suwanee, Georgia
30024, USA
contact@eltasjobs.com

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