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. 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.