Medicaid Eligibility Auditor

A company is looking for an Eligibility Staff Auditor to support the State Medicaid Program Integrity Audit initiative.

Key Responsibilities

Conduct detailed reviews of Medicaid and CHIP beneficiary eligibility determinations for compliance with regulations

Assess state Medicaid eligibility policies and procedures to ensure adherence to guidelines and identify areas of non-compliance

Prepare comprehensive audit reports summarizing findings, recommendations, and corrective action plans

Required Qualifications

Bachelor's degree in public health, business administration, public administration, accounting, or a related field; master's degree preferred

Minimum 3 years of experience with federal entitlement programs such as Medicaid or CHIP

Proven experience conducting compliance assessments or audits of federal or state programs

Proficiency with Microsoft Office applications and analytical tools for data evaluation

U.S. citizenship, Green Card, or valid work authorization