Auditor, Special Investigations
Company: Blue Cross & Blue Shield of Mississippi
Location: Flowood
Posted on: April 2, 2026
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Job Description:
Healthy Careers Start Here At Blue Cross & Blue Shield of
Mississippi, we encourage professional growth in a challenging and
fast-paced atmosphere. Our 'be healthy' culture promotes health and
wellness at all levels of the Company, and we provide our employees
with the time, tools and resources to commit to a healthy
lifestyle. The incumbent is responsible for conducting
comprehensive audits of Network Providers (Institutional,
Professionals and Allied) for compliance and to identify and
remediate Provider fraud, waste and/or abuse. The incumbent
collaborates with Management and the Provider Compliance team to
implement proactive Provider billing monitoring designed to
identify potential fraud, waste and abuse. The incumbent is
responsible for collaborates with the Clinical Quality and Claims
Operations Business Areas to identify and address fraud, waste and
abuse and implement controls to address identified fraud, waste and
abuse and quality issues. Job-Specific Requirements: A Bachelor’s
Degree in Business or other health related field is required. Three
(3) years audit experience required with experience in auditing
Institutional providers or other related provider auditing is
preferred. Healthcare experience preferred. Experience in
interpretation of data analysis and analytical reporting is
required. PC skills required to include the Microsoft Office Suite.
Effective oral and written communications skills. Blue Cross & Blue
Shield of Mississippi is an Equal opportunity Employer. All
qualified applicants will receive consideration for employment
without regard to race, color, religion, sex, sexual orientation,
gender identity, national origin, disability or protected veteran
status. We offer a comprehensive benefits package that is worth
approximately one-third of the salary compensation. Our benefits
program is among the best in the health care field. We are looking
for employees who can bring their experience, expertise and
dedication to work for our customers.
Keywords: Blue Cross & Blue Shield of Mississippi, Jackson , Auditor, Special Investigations, Healthcare , Flowood, Mississippi
