Hiring: Financial Compliance Auditor III Claims Company: L.A. Care Health Plan Location: Los Angeles County, CA Job Posted Time: 2026-09-12 15:12:25 Employment Type: On-site Target Skills & Keywords : Medicare, Microsoft Excel, Regulatory Compliance About the job Experience: •At least 4 years of experience performing claims audits or claims processing related to Medi-Cal, Medicare, and/or other managed care product lines similar to L.A. Care’s L.A. Care Covered and PASC-SEIU programs. Required Skills: •Acts as a Subject Matter Expert, serves as a resource and mentor for other staff. •Performs auditing procedures under minimal supervision during the audits of PPGs, hospitals and health plans. •Conducts sub-delegation claims oversight audits of the PPGs, capitated hospitals, and the Plan Partners. This includes all claims processing sub-contracting functions of the delegates. •Provides timely and accurate reports that detail whether PPGs, hospitals and health plans are meeting certain regulatory and contractual requirements. •Presents timely reports to supervisor within one week of audit date. Additionally, reports any finding/issues that affect the audits results. •Prepares documentation needed prior to onsite claim audits timely. •Performs ongoing tasks as assigned by the manager of Financial Compliance which may include compiling Monthly Timeliness Report (MTR) and audit reports of the Plan Partner oversight of their Independent Practice Association (IPA) network on a quarterly & annual basis. •Performs other duties as assigned. Qualifications: •Master's Degree •The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. •L.A. Care Offers a Wide Range Of Benefits Including Paid Time Off (PTO) Interested candidates, please apply directly through the job posting on company's career page or try via AI auto apply on this platform. Don't miss this opportunity to join a forward-thinking team!