Eligibility Staff Auditor

📋 Description

• Review Medicaid and CHIP eligibility determinations for compliance.
• Evaluate eligibility decisions on applications, redeterminations, unwinding activities, and policy
• Assess state Medicaid policies and workflows for adherence.
• Gather financial docs, identity verification, eligibility timelines, and supporting evidence.
• Use data analytics to identify trends and risk indicators needing review.
• Document vulnerabilities and corrective actions for federal stakeholders.

🎯 Requirements

• Bachelor’s in public health, public/admin, accounting, or related; master’s preferred.
• 3+ years Medicaid/CHIP auditing or 1 year with master’s degree.
• Experience in compliance assessments and program audits.
• Strong knowledge of Medicaid terminology and program requirements.
• Risk assessment methodologies and program integrity principles.
• Proficiency with MS Office and data evaluation tools.

🎁 Benefits

• Fully remote work environment within the United States.
• Competitive compensation with potential bonus.
• Employer-paid healthcare benefits.
• 401(k) with employer match.
• Training and professional development funding.
• Impactful work in federal healthcare oversight.