Arizona Licensed Program Integrity Auditor

Arizona Licensed Program Integrity Auditor is a full-time position responsible for reviewing medical records to ensure compliance with coding and documentation standards, while also identifying potential fraud, waste, or abuse. Key Responsibilities Conduct routine and ad hoc audits of provider records across multiple lines of business to ensure compliance with regulatory standards Identify and report aberrant billing patterns and potential fraud, waste, or abuse to internal staff and assist in investigations Provide technical assistance and education to providers regarding regulatory requirements and coding rules Required Qualifications 3-5 years of experience in reviewing claims data and medical records 3-5 years of experience with industry coding guidelines such as CPT, HCPCs, and ICD-10 Active CPC, CCS, or CPMA license required Willingness to work Monday-Friday from 8am-5pm Arizona Time Zone Associate's degree or equivalent experience (2+ years of relevant experience + high school diploma or GED)