Remote Auditor, Delegate ODAG

Job Summary

A company is looking for a Remote Auditor, Delegate ODAG.

Key Responsibilities

• Conduct detailed audits of delegated entities' ODAG universe submissions for accuracy and compliance
• Support CMS ODAG audit preparedness by validating submissions and assisting in audit preparation
• Engage with delegated entities to improve data quality and validate corrective actions

Required Qualifications, Training, and Education

• Minimum 7 years of claims experience in an HMO, Medicare Advantage, and/or IPA setting
• Prior Medicare Managed Care ODAG experience related to delegation oversight and auditing
• Minimum 5 years of experience conducting oversight audits of delegated entities
• High school diploma required; Bachelor's degree in a related subject preferred
• Strong knowledge of Medicare audit processes and applicable regulatory requirements