Auditor II - Data Mining

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