At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

The Audit Specialist Analyst II is responsible for independently executing internal and external audits, interpreting audit findings, validating compliance with contractual performance guarantees, and supporting broader quality assurance initiatives. This role requires advanced knowledge of Affordable Care Act, Commercial, Medicare and Medicaid reimbursement methodologies, including facility, ancillary, and professional claims, as well as the ability to analyze claim calculations, interpret provider contracts, collaborate with cross-functional teams, and identify opportunities to improve audit accuracy, compliance, and operational performance.

Required Job Qualifications:

• Bachelor’s degree or equivalent experience in claims processing or audit.

• 2 years in audit or claims review.

• Familiarity with adjudication systems.

• Proficient in Microsoft Office and audit software.

• Strong analytical and communication skills.

Preferred Job Qualifications:

• Experience in payment integrity or provider contracting – HIGHLY PREFERRED

• Extensive experience across ACA, Commercial, Medicare, and Medicaid plans, including reimbursement methodologies and payment structures

• Strong expertise in facility, ancillary, and professional billing, coding, and reimbursement practices

• Proven ability to interpret provider contracts and perform detailed claim reviews, calculations, and variance analysis

• Advanced analytical, critical thinking, and problem-solving skills to assess risks and recommend corrective actions

• Excellent communication and collaboration skills, with the ability to present findings, manage priorities independently, and partner effectively across stakeholders

Sponsorship will not be provided for this role.

This is a Telecommute (Remote) role.

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Compensation: $41,700.00 - $92,800.00

Exact compensation may vary based on skills, experience, and location

HCSC Employment Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

To learn more about available benefits, please click https://careers.hcsc.com/totalrewards