Director of Payor Audits

Role Overview

• 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!!