Senior Medical Audit Specialist
External
Okgov · Oklahoma CountyPart-timeOn-siteToday
ComplianceDocumentationLeadership
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Benefits
$78,465.00/annualWhy You'll Love Working HereLet's Talk BenefitsWe know your great work deserves great support. Here's a snapshot of what we offer for all eligible employees.Generous state-paid benefit allowance to offset insurance premiums.A wide selection of insurance plans with no pre-existing condition exclusions.Flexible Spending Accounts for health care and dependent care.Retirement Savings Plan with employer contributions.11 paid holidays annually.15 days of vacation and 15 days of sick leave in the first year.Longevity Bonus recognizing years of public service.Public Service Loan Forgiveness eligibility and tuition reimbursement.Wellness benefits, including an on-site gym and fitness center discounts.Job DescriptionLocation: 4345 N Lincoln Blvd, Oklahoma City, OK 73105Salary: $78,465.00/annualWork Schedule: Monday - FridayPrimary Hours: 8:00 a.m. - 5:00 p.m.Agency/Division InformationPosition PurposePrincip al Activities May Include :Provide clinical expertise in conducting investigations and completing comprehensive clinical audits in an effort to combat fraud, waste, and abuse.Ensure billing compliance with OHCA policy, state statutes, and federal regulations.Performs analysis and evaluation of billed services including claims and documentation to ensure all HCA policy requirements are met and services are clinically/medically appropriate .Collaborate with others across the unit, organization, and external entities to evaluate audit results and make referrals to appropriate parties .Communicate audit findings to all stakeholders.Represents the Provider Audits Unit before an Administrative Law Judge (ALJ) and in legal proceedings regarding any general provider appeals, in an informed and professional manner.Maintain licensure and certifications.Other duties as assigned.Knowledge, Skills, Abilities and Competenc y RequirementsThe best-fitting Korn Ferry competencies for this position include Ensures Accountability, as the role focuses on enforcing compliance and managing responsibilities, and Collaborates , given the need for cross-functional teamwork and stakeholder engagement.**To be considered for this position your application must include a resume/CV with complete work and education history.**Education and/or Experience:Possession of a valid permanent Oklahoma license as a registered nurse as approved by the Oklahoma Board of Nursing or Registered Nurse License recognized by the Enhanced Nurse Licensure Compact (eNLC)General understandingHealth insuranceVision insurancePaid time offFlexible schedulePerformance bonus
Additional Information
Job Posting Title Senior Medical Audit Specialist Agency 807 HEALTH CARE AUTHORITY Supervisory Organization Program Integrity & Account Job Posting End Date Refer to the date listed at the top of this posting, if available. Continuous if date is blank. Note: Applications will be accepted until 11:59 PM on the day prior to the posting end date above. Estimated Appointment End Date (Continuous if Blank) Full/Part-Time Full time Job Type Regular
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