Healthcare Auditor (req-167)
Healthcare Auditor (req-167)
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$ 50000 - 70000
1 Vacancy
Job Description
Team CATHEXIS elevates the government contracting experience through rapid response deep skill and thoughtful problem-solving and communication. Our core capabilities are our top-tier program and project management data analytics and audit services the backbone of which is our integrated approach to operational excellence.
You worked hard to get to where you are. You strive to make every day better than the day before. So do we. Team CATHEXIS operates with an all-in mindset. We are working together to create a company that supports our shared values and individual goals. Our values are centered around Respect Integrity Teamwork and Excellence in everything we do for our employees clients partners and communities. We believe success is best when we listen and lead with empathy; model high standards of ethics to provide a rewarding candidate experience; work hard have fun and appreciate the strengths we all bring to the team; and empower our employees to create innovative and trusted results.
We are looking for a dynamic Healthcare Auditor to join our team! This role offers a rewarding opportunity to conduct independent standards-based audits supporting the Department of Veterans Affairs in preventing fraud waste and abuse. The position combines meaningful work with collaborative planning and audit team engagement across high-impact federal healthcare contracts.
Responsibilities:
- Responsible for independent and objective evaluation and documentation of observations/findings based on reviews of medical records and claims as they pertain to fraud waste and abuse as assigned
- Complete medical record reviews using knowledge of medical procedures Medicare policies coding guidelines etc. as assigned
- Utilize coding conventions detect fraud schemes evaluate reimbursement practices and apply pertinent laws rules and regulations to identify fraudulent billing patterns in claims documentation service authorization etc.
- Maintain a thorough understanding of applicable laws rules regulations coding and billing standards VA policies and contractual provisions and related requirements necessary to perform criteria-based audits
- Prepare audit working paper documentation supporting fieldwork and conclusions by GAGAS standards as assigned
- Engage with team members to gather requirements and validate results
- The Auditor works independently and as part of an auditing team supporting comprehensive audits of contractors electronic medical records other documentation and invoices. The audits are of vendors who provide Medical Disability Exams in support of the Department of Veterans Affairs
- Perform other duties as required
Requirements:
- Must have an active Public Trust or the ability to obtain and maintain a Public Trust which requires U.S. citizenship a favorable background check (including criminal credit and employment history)
- Bachelors degree (BS/BA) with three (3) or more years of relevant experience or Masters degree (MS/MA) with no experience required or Certified Physical Therapist (or similar licensed medical professional) with four (4) or more years of experience may qualify under a documented waiver process
- Experience auditing by professional standards and industry best practices required
- Knowledge of government payor practices guidelines and procedures; knowledge of CPT ICD-9 ICD-10 and HCPCS coding required
- Healthcare auditing regulatory compliance or a similar combination of education and experience will be considered
- Excellent communication skills both written and verbal and proficiency in MS Word Excel and PowerPoint required
- Demonstrated ability to work independently and as a team required
- Comfortable managing multiple variable tasks with limited supervision within targeted timelines and thriving in a demanding quickly changing environment
Desired Skills:
- CPC CIA CHC and/or RHIT Certifications
- Healthcare auditing regulatory compliance or a similar combination of education and experience will be considered
CATHEXIS offers competitive compensation packages to all eligible employees. Our goal is to provide a compensation package that reflects the value you bring to our team is competitive with market rates and promotes your financial security and personal well-being. The annual salary range for this role is $50000 - $70000. Please note that the salary information provided is a general guideline. CATHEXIS considers various factors in its final offer including location qualifications experience and skills.
Benefits:
- Performance Bonuses
- Medical Insurance
- Dental Insurance
- Vision Insurance
- 401(k) Plan (Traditional and ROTH)
- Life Insurance (Basic Voluntary & AD&D)
- Paid Time Off
- 11 Federal Holidays
- Parental Leave
- Commuter Benefits
- Short Term & Long Term Disability
- Training & Development
- Wellness Program
- Community Outreach Initiatives
CATHEXIS is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to sex gender identity sexual orientation race color religion national origin disability protected Veteran status age or any other characteristic protected by law. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process please contact
Employment Type
Full-Time
