LiveWell Centers ยท 18 hours ago
Claims Audit Manager (Hybrid)
Philadelphia, PA
Full-time
Hybrid
Mid, Senior LevelLiveWell Centers is a dedicated healthcare organization seeking a detail-oriented Claims Audit Manager to lead pre- and post-payment audits across their facilities. This role is critical in ensuring regulatory compliance and minimizing financial risk through accurate audit execution and reporting.
Hospital & Health Care
Responsibilities
Manage all aspects of claims audits, including CMS, TPE, Medicaid, Medicare, and Managed Care audits
Collect and prepare comprehensive audit documentation
Communicate directly with facility teams and external auditors to resolve issues
Facilitate onsite visits as needed to support audit activities
Ensure timely and accurate submission of all audits
Track audit outcomes, identify trends, and initiate corrective action plans
Maintain strong relationships with internal and external stakeholders
Monitor regulatory changes and incorporate best practices
Recommend process improvements to enhance compliance and efficiency
Qualification
Required
MDS experience required (LNAC or RNAC strongly preferred)
Prior experience in claims auditing or healthcare compliance
In-depth knowledge of Medicare, Medicaid, Managed Care, and CMS audit regulations
Strong analytical, organizational, and communication skills
Ability to work independently, manage multiple audits, and meet deadlines
Comfortable with occasional travel to facility sites
Benefits
Competitive salary and benefits package
Opportunities for growth and continued professional development
Company
LiveWell Centers
The #LiveWell Centers provide quality health care throughout Pennsylvania. We empower individuals to embrace a life of well-being and vitality.
1001-5000 employeesFunding
Current Stage
Late StageCompany data provided by crunchbase