Medicaid Hospital Claims Auditor

The Medicaid Hospital Claims Auditor subcontract involves performing forensic audits of Medicaid hospital claims for prime contractors working on Maryland Department of Health projects. The selected provider will utilize the Maryland Medicaid Information System to analyze claims across three hospital provider types, identifying both overpayments and underpayments while ensuring strict adherence to regulatory requirements and patient safety protocols. Key deliverables include detailed reports on identified claim discrepancies and recovery efforts. This opportunity is managed by the Maryland Office of Procurement and Support Services under NAICS code 541211. Due to the nature of the healthcare data involved, the contractor must maintain full HIPAA and MCMRA compliance and provide a signed Business Associate Agreement. Interested parties must submit their responses by November 20, 2026.