Title: Post Payment Auditor

Job Summary :

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

Major duties and responsibilities include but are not limited to :

• Work with providers to receive necessary data and documentation for post-payment desk and on-site audits. Audit type will be determined based on statistical analysis of a series of factors included in the risk assessment. Providers will be required to submit a completed audit forms with supporting documentation prior to the audit being conducted. A summary of findings will be completed for each audit, with feedback given to all appropriate parties. Individual and aggregate findings will be calculated and reported to state and federal stakeholders and will include trends and indicators by provider type, suggested follow-up and applicable best practices from other states if any actionable barriers or issues are identified. 35% Desk, 5% On-site.
• Evaluating provider attestations, records, and data for validation of AHCCCS incentive program requirements. Determinations will be made to approve or deny. Post payment audit determinations should be communicated with all appropriate parties responsible for processing attestations at the Agency, in accordance with established time frames.
• Researching, monitoring and evaluating best practices and evidence-based interventions for possible implementation by AHCCCS and its stakeholders to improve auditing performance. Recommending quality improvement activities / strategies for implementation and leading or participating in work groups with stakeholders and other stakeholders to implement approved activities / strategies. Examples include but are not limited to local provider / stakeholder forums, national webinars and training sessions, and intra / inter-agency collaborations.
• Participating in system development activities to ensure that AHCCCS - designed systems meet federal and State requirements. This includes researching requirements, meeting to discuss development needs and time frames, participating in review and testing of systems, providing feedback to appropriate parties and supporting underlying processes to ensure timely completion of all related initiatives undertaken.
• Other duties as assigned as related to the position (typically 5% - 10%)

Knowledge, Skills & Abilities (KSAs) :

Knowledge :

Skills :

Abilities :

Qualifications : Minimum :

Preferred :

Pre-Employment Requirements :

If this position requires driving or the use of a vehicle as an essential function of the job to conduct State business, then the following requirements apply :  Driver’s License Requirements.

All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify).

Benefits :

Among the many benefits of a career with the State of Arizona, there are :

By providing the option of a full-time or part-time remote work schedule, employees enjoy improved work / life balance, report higher job satisfaction, and are more productive. Remote work is a management option and not an employee entitlement or right. An agency may terminate a remote work agreement at its discretion.

Learn more about the Paid Parental Leave pilot program here.