Provider Network Auditor

Job overview

The Provider Network Auditor role is onsite in Saginaw, MI, with pay of $62,729.36–$77,204.58 annually. Saginaw County Community Mental Health Authority supports culturally competent, recovery-based, person-centered, and trauma-informed practices. The auditor conducts program and provider audits to verify service documentation and identify deficiencies in claims, records, and compliance. Findings, corrective-action review, and reporting help safeguard against fraudulent or erroneous claims and support quality and compliance across the provider network.

What you'll do

• Establish audit samples, schedules, and plans
• conduct routine, annual, or ad hoc audits and provider reviews
• identify deficiencies and recommend corrective actions
• present findings to providers
• review corrective action plans
• verify service events and documentation supporting authorization of funds
• prepare event verification letters and reporting data
• visit provider programs to review files
• alert management to serious findings and the Office of Recipient Rights to potential Michigan Mental Health Code issues.

What we're looking for

Skills & competencies

provider network auditor

saginaw mi

saginaw county community mental health authority

full-time

mental health services

program audits

provider compliance

quality performance

claims documentation

$62,729–$77,205/year

corrective action

on-site reviews

Work arrangement

• Weekend coverage required

Why this role

Works under the general supervision of the Provider Network Auditing Supervisor and may conduct contractor compliance reviews. Audits contracted and board-operated programs.

About the employer

Saginaw County Community Mental Health Authority is hiring for this role. Industry: Outpatient Mental Health and Substance Abuse Centers. Sector: 62.