Lead Provider Audit Analyst

Job Summary

A company is looking for a Lead Provider Audit Analyst.

Key Responsibilities

• Plan, coordinate, and execute audits of provider records, claims, and documentation
• Review and assess the quality of provider services and documentation
• Prepare detailed audit reports, analyze findings, and recommend improvements

Required Qualifications

• Bachelor's degree in Healthcare Administration, Business Administration, Finance, or related field; Master's preferred
• 5-7 years of related work experience, with a focus on auditing or quality assurance
• Certifications such as Certified Professional Medical Auditor (CPMA) may be advantageous
• Experience in healthcare or insurance auditing is preferred
• Proficiency in data analysis and reporting tools such as Excel, Access, SQL, or Tableau