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Aeroflow Health

Empowering Patients, Elevating Healthcare | Your Wellness, Our Commitment

Director of Payor Audits

DirectorDirectorFull TimeRemoteLeadTeam 501-1,000Since 2001H1B No SponsorCompany SiteLinkedIn

Location

North Carolina

Posted

27 days ago

Salary

Not specified

Seniority

Lead

Bachelor Degree5 yrs expEnglish

Job Description

• Lead all external audits, including Medicaid, Medicare, and commercial payors • Serve as the primary point of contact for commercial and payor audits • Oversee audit responses, rebuttals, corrective action plans, and appeals • Partner with Legal to ensure the company speaks with one voice during audits • Track audit outcomes, recoupments, pre-pay activity, and financial exposure • Design and implement a robust internal audit and monitoring program, built from the ground up • Use audit findings to inform policy updates, training, and operational improvements • Identify root causes and drive sustainable remediation across teams • Advise executive leadership on audit risk, mitigation strategies, and resource needs • Lead and develop audit staff, setting expectations and raising performance • Navigate audits across multiple state Medicaid manuals, understanding the nuance and variation by state • Operate effectively within a large, multi-state, national organization

Job Requirements

  • Certified Fraud Examiner (CFE) credential
  • Direct government audit experience, with strong preference for Medicaid
  • Experience auditing DME or similarly regulated healthcare environments
  • Hands-on experience managing audits across multiple states
  • At least 5+ years of pure audit experience, with leadership responsibility
  • Willingness to travel to Headquarters (Asheville, NC) on a monthly basis

Benefits

  • Competitive Pay
  • Health Plans with FSA or HSA options
  • Dental and Vision Insurance
  • Optional Life Insurance
  • 401K with Company Match
  • 12 weeks of parental leave for birthing parent/ 4 weeks leave for non-birthing parent(s)
  • Additional Parental benefits to include fertility stipends, free diapers, breast pump
  • Paid Holidays
  • PTO Accrual from day one
  • Employee Assistance Programs and SO MUCH MORE!!

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