North Carolina Audit Consultant

Job Summary

Supporting North Carolina Medicaid, the full-time remote Audit Resolution Consultant will compute erroneous payments, examine county eligibility errors from audits, and coordinate with various stakeholders to enhance audit processes and ensure financial accountability.

Key responsibilities:

• Compute erroneous Medicaid payment amounts based on county eligibility errors
• Examine county eligibility error findings to identify and calculate overpayment amounts
• Review claims payment data in NCTracks to verify service codes and beneficiary eligibility history

Required qualifications:

• Master's degree in a relevant discipline and two years of related experience, or a Bachelor's degree and four years of related experience
• Experience navigating and analyzing NCFAST system decisions with at least three years of documented use
• Proven success in reviewing and interpreting Medicaid eligibility audit findings
• Established experience analyzing Medicaid claims and eligibility discrepancies
• Effective communication skills with internal and external stakeholders for audit coordination