Senior Healthcare Auditor

Job Summary

A company is looking for a Senior Healthcare Auditor to support the Department of Veterans Affairs in ensuring proper billing practices and reducing fraud, waste, and abuse.

Key Responsibilities:

• Evaluate and document findings from medical records and claims related to fraud, waste, and abuse
• Conduct proactive medical record reviews and apply knowledge of coding guidelines and Medicare policies
• Prepare audit documentation and assist in summarizing audit results for formal reports

Required Qualifications:

• Active Public Trust or ability to obtain it, requiring U.S. citizenship and a favorable background check
• RN or other licensed medical professional preferred, or five years of relevant experience with two to four years in healthcare auditing
• Seven years of relevant experience required if lacking healthcare auditing experience
• Experience with auditing by professional standards and knowledge of coding practices (CPT, ICD-9, ICD-10, HCPCS)
• Demonstrated ability to work independently and as part of a team in a fast-paced environment