GENERAL SUMMARY OF POSITION:
Under the general direction of the Associate Director or designee, the Program Auditor serves a crucial role in combating fraud, waste and abuse (FWA) within the Medicaid program. A major function of this position is to conduct desk and onsite reviews based on federal and state regulations that govern provider types. Audits involve extensive research to identify industry trends and patterns in order to detect aberrant billing practices. Working independently, or within a team, the Auditor performs all activities related to data mining, claims analysis, and auditing. The auditor will participate in face to face entrance and exit conferences with providers utilizing established interviewing skills.