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Medicaid Claims Auditor

Nashville, TN
Analytica is seeking a Medicaid Claims Auditor to support a project with a federal healthcare client.  This position allows for remote work.

Primary Responsibilities Include (But Are Not Necessarily Limited To):
  • Perform routine and complex claims audits to identify inaccurate adjudications 
  • Daily production and audit of focused reports to include tracking, researching, and documenting audit findings 
  • Determine origin and appropriate resolution of audit findings
  • Summarize findings and recommendations for feedback to the Claims Team
  • Review claims audit results with the Claims Supervisor and management
  • Provide suggestions and input that will lead to improved processing accuracy 
  • Ensure compliance to policies, procedures, and state and federal regulations 
Required Experience / Skills:
  • 3+ years experience as a Medicaid Claims Auditor
  • Strong computer technical skills to include Windows, keyboarding skills, and Microsoft Office suite
  • Excellent verbal and written communication skills
  • Ability to work alone with minimal oversight

About ANALYTICA: Analytica is a leading consulting and information technology solutions provider to public sector organizations supporting health, civilian, and national security missions. Founded in 2009 and headquartered in Washington D.C., the company is an established SBA certified HUBZone and 8(a) small business that has been recognized by Inc. Magazine each of the past three years as one of the 250 fastest-growing companies in the U.S.  Analytica specializes in providing software and systems engineering, information management, analytics & visualization, agile project management, and management consulting services. The company is appraised by the Software Engineering Institute (SEI) at CMMI® Maturity Level 3 and is an ISO 9001:2008 certified provider.
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