Medicaid Fraud Auditor

Peraton

. Conduct audits and reviews of Medicaid programs for compliance with federal and state requirements .

Posted 9/30/2026full-timeRemote • United StatesJuniorMid-Level💰 $51,000 - $82,000 per yearWebsite

Core Competencies

Role fit

Core 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 documentation to ensure compliance and accuracy in audit processes.

Highest-signal resume keywords

Medicaid Compliance AuditingData AnalysisResearch SkillsMicrosoft ExcelHealthcare Industry Knowledge

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Compliance AuditingData AnalysisResearch and Interpretation of LawsAudit/Investigative SkillsMedical Coding ConceptsFinancial AcumenProject Management

Soft Skills

Organizational SkillsCommunication SkillsAttention to Detail

Tools & Technologies

Microsoft Office

Industry Keywords

MedicaidHealthcare AuditingInternal Audit PoliciesBilling PatternsFraud Schemes

About the role

Key responsibilities & impact

Conduct audits and reviews of Medicaid programs for compliance with federal and state requirements
Recover over-payments resulting from non-compliance
Research and interpret laws and regulations
Perform data analysis and draw conclusions
Conduct compliance audits of varied Medicaid case types and audit claim submissions
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
Provide progress reports and audit-status updates
Present data-verified concerns, regulatory violations, and fraud schemes
Compose correspondence, reports, and referral summary letters
Attend meetings and training
Ensure projects are timely, complete, and accurate

Requirements

What you’ll need

2 years with BS/BA or 6 years with a high school diploma
Experience in accounting or a 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
Intermediate to advanced knowledge of Microsoft Office tools, including Excel
Must be a US Citizen
Intermediate financial and business acumen
Intermediate audit/investigative skills
Project management skills
Knowledge of the healthcare industry and medical coding concepts and/or experience analyzing healthcare claims data preferred

Benefits

Comp & perks

Employees may be eligible for overtime
Shift differential may be available
Discretionary bonus may be available