Auditor II - Data Mining

Job Summary

Working remotely, the full-time Auditor II - Data Mining will review query outputs to identify potential overpayments and perform audits in accordance with internal policies and regulations.

Key responsibilities

• Review output of queries for overpayments and validate findings using claims systems
• Document overpayments and non-overpayments in production systems, providing clear reasons for research purposes
• Communicate with management regarding any issues that may impede work completion and provide feedback for improvements

Required qualifications

• High School Diploma or Equivalent Required; College Degree or Equivalent Work Experience preferred
• Knowledge of CMS guidelines and strong understanding of HCPC, CPT, and other coding methodologies
• 1-2 years of experience as an Auditor or in Medical Claims Processing preferred
• Ability to learn and apply new technologies effectively
• Maintain OIG/GSA clearances