Qlarant · 9 hours ago
Auditor/Investigator I
United States
Full-time
Remote
New Grad, Entry Level
$48K/yr - $72K/yr
0+ years expQlarant is a not-for-profit corporation that partners with public and private sectors to enhance the delivery of health care and human services. The Auditor/Investigator I role is responsible for ensuring the integrity and accuracy of claims processes through audits and investigations, while identifying fraud, waste, and abuse in claims submissions.
Information ServicesInformation Technology
Responsibilities
Conducts routine and impartial audits/investigations into customer claims, ensuring accurate and fair assessments of claims validity
Provides customer service by addressing inquiries and concerns, and escalates audit/investigation, as needed
Compiles detailed and organized records of audit/investigation findings, ensuring accuracy and compliance with legal and regulatory requirements
Applies functional knowledge to create and implement strategies to identify and prevent fraudulent activities, safeguarding the integrity of the claims process
Conducts interviews with relevant witnesses, claimants, and other stakeholders to gather additional information and perspectives on claims
Communicates with appropriate internal teams to ensure the proper processing of audits/investigations, while adhering to legal and regulatory standards
Ensures that all audit and investigative documents and records are processed into the database in a timely and accurate manner
Communicates audit/investigation findings clearly and professionally to customers, claimants, and other stakeholders, managing expectations and providing updates
Supports management in regular audit and investigation proceedings, ensuring full compliance with all applicable regional and federal standards, regulations, and protocols
Qualification
Required
Minimum Bachelor's Degree required
0 - 2 years of experience required
Preferred
2 - 4 years preferred
Prior experience in healthcare fraud or investigation
Working knowledge of Medicare preferred
Certified Fraud Examiner or Accredited Healthcare Anti-Fraud Investigator preferred
Company
Qlarant
Qlarant is a not-for-profit, nationally respected in fighting fraud, waste, and abuse—improving program quality, and optimizing performance.
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
Christine Leister
Chief Financial Officer
Recent News
2025-12-04
PR Newswire
2025-09-17
Qlarant Foundation
2025-07-15
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