Post Auditor

AHCCCS Arizona Health Care Cost Containment System

Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Courage, Teamwork.

The Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid agency, is driven by its mission to deliver comprehensive, cost-effective health care to Arizonans in need. AHCCCS is a nationally acclaimed model among Medicaid programs and a recipient of multiple awards for excellence in workplace effectiveness and flexibility.

AHCCCS employees are passionate about their work, committed to high performance, and dedicated to serving the citizens of Arizona. Among government agencies, AHCCCS is recognized for high employee engagement and satisfaction, supportive leadership, and flexible work environments, including remote work opportunities. With career paths for seasoned professionals in a variety of fields, entry‑level positions, and internship opportunities, AHCCCS offers meaningful career opportunities in a competitive industry.

Come join our dynamic and dedicated team.

Address: 150 North 18th Avenue Phoenix, Arizona 85007

All AHCCCS Employees must reside within the state of Arizona.

Salary: $50,000 - $55,000

FLSA Status:
Exempt

Grade: 21

This position will remain open until filled.

This position will report to an Audit Supervisor in the AHCCCS Office of Inspector General (OIG). This position will be responsible for auditing providers; providing technical assistance; working interdependently and in a team environment. This individual will be working with providers, and internal staff to obtain required documentation, process information, analyze, and generate required reports and correspondence.

• Audit providers and request necessary data and documentation for post‑payment desk and on‑site audits. Summarize audit findings for each audit and provide feedback to all appropriate parties. Individual and aggregate findings will be calculated and reported to state and federal stakeholders as required.
• Audit providers and request necessary data and documentation for incentive programs desk and on‑site audits. Evaluate provider attestations, records, and data for validation of AHCCCS incentive program requirements. Determine if program requirements were met and if incentive payment was allowable. Audit findings will be communicated with the provider once determined.
• Analyze and interpret data to effectively communicate the audit results.
• Interact with internal and external customers at various levels, providing guidance and technical assistance as needed.
• Assist in the development of internal and external audit processes.
• Review Federal and State regulations, contracts, policies, and guidelines to ensure compliance when conducting audits.

Knowledge:

• AHCCCS Incentive Programs
• Strong understanding of research and statistical analyses
• AHCCCS, State and Federal Policies and Procedures governing Medicaid and health care
• Background and knowledge of quality management principles and quality improvement organizations (National Committee for Quality Assurance)
• Thorough knowledge of HIPAA and the rules pertaining to the sharing of investigative information
• Relevant statutes and laws pertaining to the auditing of Medicaid and AHCCCS programs
• Claims processing and procedures with providers and MCOs
• Preparation of computerized spreadsheets which support audit findings

Skills:

• Research, data analysis, and problem solving
• Computer skills that include Microsoft Office including Outlook and Excel
• Written and verbal communication to include report writing and speaking to various levels of leadership.
• Applying contract and policy language to documents being reviewed composed
• Take initiative in order to complete tasks in a timely manner.
• Organizational skills that result in prioritization of multiple tasks and meet deadlines
• Conflict resolution

Abilities:

• Analyze, interpret and communicate data, communicate effectively both verbally and in writing, and analyze large amounts of complex information and data
• Conduct multiple audits…