Director of Payor Audits
Aeroflow Health
full-time
Posted on:
Location Type: Remote
Location: North Carolina • United States
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Job Level
About the role
- 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
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!!
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
audit managementcorrective action plansfinancial exposure trackingpolicy updatesoperational improvementsroot cause analysisaudit risk mitigationmulti-state audit navigationDME auditing
Soft Skills
leadershipcommunicationcollaborationperformance managementstrategic advising
Certifications
Certified Fraud Examiner (CFE)