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Posted: 10/20/2026Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in conducting compliance audits and reviews of Medicaid programs, with strong analytical skills to interpret laws and regulations. Proficient in data analysis, project management, and effective communication of findings.
Highest-signal resume keywords
Medicaid Compliance AuditingData AnalysisResearch SkillsMicrosoft ExcelHealthcare Industry Knowledge
About the role
Key responsibilities & impact- Conduct audits and reviews of various Medicaid programs for compliance with federal and state Medicaid requirements
- Recover over-payments for non-compliance
- Research and interpret laws and regulations
- Perform data analysis and draw conclusions for projects
- Conduct compliance audits of varied Medicaid case types, audit claim submissions, and perform ad hoc focused audits
- Organize and analyze billing patterns
- Conduct interviews and obtain statements from beneficiaries/recipients and others
- Identify findings, compliance exceptions, conflicts of interest, and improper payments
- Organize case files and accurately document all steps taken
- Work independently or as part of a team and provide progress reports and audit-status updates
- Present issues of concern supported by data and cite regulatory violations
- Compose correspondence, reports, and referral summary letters
- Ensure projects are timely, complete, and accurate
- Participate in meetings and attend training
Requirements
What you’ll need- 2 years with BS/BA or 6 years with a high school diploma
- Experience in accounting or closely related business field, law enforcement, health science or related field
- Knowledge of internal audit/investigative policies and operating principles
- Understanding of Medicare/Medicaid or healthcare auditing
- Strong research and analytical skills
- Strong familiarity with Microsoft Office tools, including intermediate to advanced knowledge of Excel
- Must be a US Citizen
- Intermediate financial and business acumen preferred
- Intermediate audit/investigative skills preferred
- Project management skills preferred
- Knowledge of the healthcare industry and medical coding concepts and/or experience analyzing healthcare claims data preferred
Benefits
Comp & perks- Telework available from any state in the US
- Employees may be eligible for overtime
- Employees may be eligible for shift differential
- Employees may be eligible for a discretionary bonus
- Equal opportunity employment, including disability and protected veterans
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Compliance AuditingData AnalysisResearch SkillsAudit Investigative SkillsMedical Coding ConceptsFinancial AcumenProject Management SkillsBilling Pattern AnalysisRegulatory InterpretationClaim Submission Auditing
Soft Skills
Organizational SkillsCommunication SkillsTeam CollaborationIndependent WorkAttention to Detail
Tools & Technologies
Microsoft Office
Industry Keywords
MedicaidHealthcare AuditingInternal Audit PoliciesCompliance ExceptionsImproper PaymentsBeneficiary InterviewsRegulatory ViolationsHealthcare Claims Data