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Empowering Patients, Elevating Healthcare | Your Wellness, Our Commitment
Director of Payor Audits
Location
North Carolina
Posted
123 days ago
Salary
0
Seniority
Lead
Job Description
Director of Payor Audits
Aeroflow Health
• 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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