25 audit specialist jobs found in Nashville, TN

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Client Audit Specialist - Remote Job Description As a member of the Client Audit Management (CAM) team, the Client Audit Specialist is accountable for independently, or in collaboration with senior staff or compliance leader, managing regulatory and/or client-initiated audits. The Specialist is responsible for evaluating and understanding the purpose of various audit types and the related deliverables, developing a holistic understanding of the audit management process, and managing the end-to-end audit activities. This position seeks and obtains additional expertise as indicated from respective Compliance and Operational subject matter experts to meet applicable regulatory, client, and/or functional audit expectations....

About Us SolomonEdwardsGroup, LLC ("SolomonEdwards") is a full-service professional services firm offering financial, operational, and technology consulting and operations support. We work with some of the world's most prominent companies to help them envision and achieve a better future. We know that our consulting services are only as meaningful as the people and talent behind them, and we are committed to recruiting incredibly talented, committed, and collaborative individuals who can help us deliver exceptional client service. For more information, visit SolomonEdwards Position Summary: We are seeking a Senior Technical Implementation Lead with deep expertise in Anti-Money Laundering (AML) and Fraud Transaction Monitoring Systems to design, implement, and optimize enterprise-scale monitoring solutions across our U.S. banking operations. This individual will play a key role in delivering technology solutions that strengthen our Client's financial crime detection...

Job Description Oracle's Global Physical Security (GPS) Systems Team is responsible for securing the corporation's global datacenter and facility footprint through advanced Physical Access and Identity Management (PIAM) technologies. We are seeking a seasoned Technical Program Manager (TPM) for Wireless Intrusion Detection Systems (WIDS) who will own the end-to-end lifecycle of enterprise wireless detection, monitoring, and counter-surveillance solutions for a complex and global security environment. Reporting to the Director, Physical Security Products & Services, you will lead the technical roadmap, policies, education, and integrations necessary for WIDS excellence-partnering closely with security operations, engineering, data center operations, and end-user groups. Responsibilities Product & Program Ownership Own the lifecycle management, standards, and feature evolution for all Wireless Intrusion Detection Systems (WIDS), including integration with...

Job Description Oracle Health Data Intelligence (HDI) is entering a critical phase of regulatory and security modernization across our global health analytics and AI-enabled population health platform. As HDI accelerates readiness for MDR (Medical Device Regulation), AI regulatory requirements, and emerging global security standards, we are expanding our Security Architecture team with specialists who bring deep technical expertise, cloud security experience, and strong regulatory awareness. We are hiring Security Architecture Specialists who can design, review, and validate secure architectures across cloud-native healthcare systems, AI/ML pipelines, and distributed data platforms. This role is ideal for someone with experience performing CSSAP-style reviews , cloud security assessments, threat modeling, and providing technical guidance that aligns engineering execution with security and regulatory expectations. You will play a key role in ensuring that HDI's...

Coding Quality Review Specialist (CQR) Location: Nashville, TN (Remote / Work From Home) Employment Type: Full-Time Why This Role Is a Great Opportunity Fully remote position with a stable, full-time schedule Work on high-impact quality initiatives across multiple hospital systems Competitive compensation based on experience Join a nationally recognized healthcare revenue cycle environment Role Overview Perform internal quality reviews for inpatient and outpatient coding teams Ensure accurate, compliant coding aligned with national guidelines and internal policies Support reimbursement integrity and clinical data accuracy across hospital settings Key Responsibilities Conduct routine, pre-bill, policy-driven, and incentive-based quality audits Review inpatient MS-DRG medical records across all body systems Perform quality reviews for both inpatient and outpatient hospital coding Ensure coder adherence...

Dialysis Clinic, Inc. is recruiting top talent interested in supporting our nonprofit mission to prioritize individualized care for patients facing chronic kidney disease. Our mission states “the care of the patient is our reason for existence,” and our dedicated team embodies our sole purpose during every patient interaction. We seek motivated, compassionate individuals to provide top-notch patient care and offer paid training, competitive pay, outstanding benefits, Sundays off and a positive, mission-driven culture. Join DCI today to build relationships and gain fulfillment serving individuals in our comfortable clinical setting with a lower caregiver-to-patient ratio than other providers. The Accounts Receivable Collection Specialist ensures timely and accurate processing of incoming payments and maintains financial records related to customer accounts. This role supports the financial health of the organization by managing billing, collections, and reconciliation...

About Us SolomonEdwardsGroup, LLC ("SolomonEdwards") is a full-service professional services firm offering financial, operational, and technology consulting and operations support. We work with some of the world's most prominent companies to help them envision and achieve a better future. We know that our consulting services are only as meaningful as the people and talent behind them, and we are committed to recruiting incredibly talented, committed, and collaborative individuals who can help us deliver exceptional client service. For more information, visit SolomonEdwards Position Summary: We are seeking a Sr. Payroll Specialist to join a leading global services firm headquartered in the Mid-Atlantic region. This fully remote consulting engagement will support U.S. corporate payroll operations, processing high-volume, multi-cycle payrolls for a diverse workforce. The ideal candidate has deep hands-on experience with Workday and ADP and thrives in a fast-paced,...

Who We Are Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered, holistic, and comprehensive approach to kidney care. We believe patients living with kidney disease deserve the best care. We are committed to improving patient outcomes and improving quality of life by delaying disease progression, shifting care to the home, and accelerating kidney transplants. We help nephrologists focus on the right patients at the right time across the full care spectrum. We do this by providing them with the best-in-class interdisciplinary clinical resources, analytical insight and tools, and services to patients. We listen to the needs of our patients, our employees, and our client partners, continually working to push beyond the status quo in which the care system manages patients today. Who You Are You are devoted, compassionate, and enjoy being on the front lines of healthcare, changing the lives of patients by...

Be Part of an Extraordinary Team Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. Build the Possibilities. Make an Extraordinary Impact. Title : DRG Coding Auditor Virtual:? ? ? This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Alternate locations may be considered if candidates reside within a commuting distance...

Every day at Disney Cruise Line we take pride in bringing the magic of Disney to life. We find joy in creating cherished memories and form genuine connections with our guests. We hold each other to the highest degree and always act responsibly while ensuring the safety of fellow crew and guests. United by our Disney values, we work toward excellence in all we do. As a part of our team, you can live and work in a diverse and inclusive environment amidst a professional and supportive community. If you are ready to create unforgettable experiences and grow as a person and as a professional, apply today. Responsibilities : Serve as onboard public health specialist; responsible for training ship/island department Managers and Crew on public health Monitor DCL policies, procedures, and record keeping to ensure the operation is in compliance with all applicable national (USPHS) and international laws Coordinate US port's and Captain's weekly Food Safety and...

Job Description About the Role Oracle Health Data Intelligence (HDI) is entering a critical phase of regulatory and security modernization across our global health analytics and AI-enabled population health platform. As HDI accelerates readiness for MDR (Medical Device Regulation), AI regulatory requirements, and emerging global security standards, we are expanding our Security Architecture team with specialists who bring deep technical expertise, cloud security experience, and strong regulatory awareness. We are hiring Security Architecture Specialists who can design, review, and validate secure architectures across cloud-native healthcare systems, AI/ML pipelines, and distributed data platforms. This role is ideal for someone with experience performing CSSAP-style reviews , cloud security assessments, threat modeling, and providing technical guidance that aligns engineering execution with security and regulatory expectations. You will play a key role in ensuring...

Job Description Oracle Customer Solutions for Industries delivers Oracle solutions to customers in multiple industries. This includes the Utilities, Construction and Engineering and Communications Business Unit that delivers proven industry software applications that help companies of all types and sizes achieve competitive advantage, business performance excellence and a lower total cost of technology ownership. Oracle Utilities integrates industry-specific customer care and billing, network management, work and asset management, mobile workforce management and meter data management applications with the capabilities of Oracle's industry-leading enterprise applications, business intelligence tools, middleware, database technologies, as well as servers and storage. The software enables customers to adapt more nimbly to market deregulation, meet ever-evolving customer demands and deliver on environmental conservation commitments. Oracle Utilities delivery team enhances the...

Job Description About the Role Oracle Health Data Intelligence (HDI) is entering a critical phase of regulatory and security modernization across our global health analytics and AI-enabled population health platform. As HDI accelerates readiness for MDR (Medical Device Regulation), AI regulatory requirements, and emerging global security standards, we are expanding our Security Architecture team with specialists who bring deep technical expertise, cloud security experience, and strong regulatory awareness. We are hiring Security Architecture Specialists who can design, review, and validate secure architectures across cloud-native healthcare systems, AI/ML pipelines, and distributed data platforms. This role is ideal for someone with experience performing CSSAP-style reviews , cloud security assessments, threat modeling, and providing technical guidance that aligns engineering execution with security and regulatory expectations. You will play a key role in ensuring...

Workfront Configuration Specialist Anywhere Type: Contract Category: Development Industry: Insurance Workplace Type: Remote Reference ID: JN -122025-104729 Date Posted: 12/14/2025 Shortcut: http://careers.eliassen.com/urDlvy Description Recommended Jobs Description: *Remote | EST work hours * We seek a Senior Workfront and Fusion Consultant to support the implementation of Workfront as an Enterprise Portfolio and Project Management tool.? As the Senior Consultant, you will work closely with our Global team to elicit requirements and design future state processes that are needed to establish an optimized Workfront solution.?This role will also be responsible for end-to-end configuration of a scalable Workfront environment, leveraging Fusion where needed.? This includes object-level structure, user management, reporting and dashboards, and workflow management. The ideal candidate for this role will have a strong...

Company : Highmark Inc. Job Description : JOB SUMMARY This job will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA), using skills including but not limited to Hierarchical Condition Category (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data Validation (RADV) Audits. Works closely with physicians, team members, Quality, Compliance, partners at Enterprise and leadership to identify and deliver high quality and accurate risk adjustment coding. Supports all Remote Patient Monitoring (RPM) risk adjustment projects to comply with all CMS requirements by analyzing physician documentation and interpreting into ICD10 diagnoses and HCC disease categories. Supports other key objectives to drive capture of correct Risk Adjustment coding including...

Posting End Date: January 02, 2026 Employee Type: Regular-Full time Union/Non: This is a non-union position We are seeking a dedicated Safety Supervisor to lead the implementation of Enbridge’s Safety Management Framework across US GTM Projects. This role requires a leader to oversee the continuous improvement of our Projects Safety Management systems, working in collaboration with projects contractors to ensure alignment with organizational expectations and industry-leading standards and practices. Collaboration with project-specific safety leads and inspectors is essential to deliver cohesive safety solutions and expectations. If you would like to help guide the advancement of the Enbridge safety culture, join our team today! What You Will Do: Provides strategic leadership by: Ensuring organizational objectives are translated into the team's activities and ensuring integration with the work of other internal and external stakeholders....

Job Title: Data Annotation Specialist - English Location: Fully Remote within the U.S. (excluding California, Washington, Alaska, Colorado, Montana, New York, Puerto Rico, Nevada, Nebraska) Employment Type: Part Time (20 hours per week) We are seeking a passionate and detailed-oriented Data Annotation Specialist to support the evaluation and labeling of images, search queries and other forms of data for a large enterprise client. This person should have strong critical thinking and written skills to be able to understand challenging guidelines and articulate their understanding. Ideally, this person will have past data annotation experience, but this is not a requirement. Required Skills: Attention to Detail – Ability to consistently identify and label subtle patterns or elements. Basic Technical Literacy – Comfortable using annotation tools and understanding data formats (e.g., text, image, audio). Consistency and Accuracy – Ability to apply...

Why UKG: At UKG, the work you do matters. The code you ship, the decisions you make, and the care you show a customer all add up to real impact. Today, tens of millions of workers start and end their days with our workforce operating platform. Helping people get paid, grow in their careers, and shape the future of their industries. That's what we do. We never stop learning. We never stop challenging the norm. We push for better, and we celebrate the wins along the way. Here, you'll get flexibility that's real, benefits you can count on, and a team that succeeds together. Because at UKG, your work matters-and so do you. About the Role: The Sr HR Technology Coordinator will be responsible for leading efforts to maintain, support, and optimize our HR technology solutions. This role will lead day to day operations to ensure the system runs smoothly, technical issues are resolved timely, while providing support to COE stakeholders and employees. The Sr HR Technology...

DESCRIPTION Overview: The Associate is responsible for completing in-store food and non-food demonstrations. Acquires and maintains knowledge of products represented. Prepares, serves, and breaks down product, equipment, and supplies. Intercepts consumers and demonstrates products in a professional manner. Maintains an overall professional appearance consistent with the requirements of the job. Pay rate: 14.75-16.25/hourly RESPONSIBILITIES Possesses the aptitude and ability to gain adequate knowledge of the products represented. Has desire and ability to proactively intercept, engage, interact, and sell product to the consumer in a positive manner. Effectively communicate the features and benefits of the product. Ability to prepare and serve food samples using small appliances such as microwaves, fryers, skillets, coffee makers and knives. Maintain a clean, sterile and safe work station using cleaning chemicals. Maintains a...

Overview: The Associate is responsible for completing in-store food and non-food demonstrations. Acquires and maintains knowledge of products represented. Prepares, serves, and breaks down product, equipment, and supplies. Intercepts consumers and demonstrates products in a professional manner. Maintains an overall professional appearance consistent with the requirements of the job. Pay rate: 14.75-16.25/hourly Possesses the aptitude and ability to gain adequate knowledge of the products represented. Has desire and ability to proactively intercept, engage, interact, and sell product to the consumer in a positive manner. Effectively communicate the features and benefits of the product. Ability to prepare and serve food samples using small appliances such as microwaves, fryers, skillets, coffee makers and knives. Maintain a clean, sterile and safe work station using cleaning chemicals. Maintains a professional appearance consistent with the requirements of the...

Location: Anywhere in Country At EY, we’re all in to shape your future with confidence. We’ll help you succeed in a globally connected powerhouse of diverse teams and take your career wherever you want it to go. Join EY and help to build a better working world. Ethics and Compliance Investigations Operations Specialist – Assistant Director At EY, you’ll have the chance to build a career as unique as you are, with the global scale, support, inclusive culture, and technology to become the best version of you. And we’re counting on your unique voice and perspective to help EY become even better, too. Join us and build an exceptional experience for yourself, and a better working world for all. EY focuses on high ethical standards and integrity among its employees and expects all candidates to demonstrate these qualities. The opportunity The Ethics and Compliance Investigations Team (ECIT) is a high-performing, centralized team under Ethics, Compliance, and Risk Management...

Job Description Oracle Clinical AI Assistant (CAA) allows providers and their support staff to focus more on patient care by reducing administrative burden of clinical and reimbursement tasks such as charting, documentation, and coding by applying power of generative AI. Our diverse team of creators and inventors are building the future of conversational clinical interfaces, making real improvements in the lives of people across the world. We act with the speed and attitude of a start-up, but with the scale and customer focus of the world's leading enterprise software company. We have a big charter and a lot of creative freedom to get it done. Come join us and grow your career in this exciting arena. We are looking for a Senior Claims Denial Prevention and Appeals Specialist for providing clinical inputs to engineering for developing the Claim Denial Prevention and Appeals features of Oracle Health Clinical AI Agent (CAA). This role leverages expert clinical judgment and...

Job Title: Generative AI Specialist - Humanities (English and Swedish) Location: Fully Remote within the U.S. (excluding California, Washington, Alaska, Colorado, Montana, New York, Puerto Rico, Nevada, Nebraska) Employment Type: Part Time (max 28 hours per week) Who we are: Innodata (NASDAQ: INOD) is a leading data engineering company. With more than 2,000 customers and operations in 13 cities around the world, we are an AI technology solutions provider-of-choice for 4 out of 5 of the world’s biggest technology companies, as well as leading companies across financial services, insurance, technology, law, and medicine. By combining advanced machine learning and artificial intelligence (ML/AI) technologies, a global workforce of subject matter experts, and a high-security infrastructure, we’re helping usher in the promise of AI. Innodata offers a powerful combination of both digital data solutions and easy-to-use, high-quality platforms. Our global...

Summary The Placement Support Specialist I contributes to program excellence and integrity by working to maintain the appropriate number of admissions to the Therapeutic Foster Care program and carrying out assigned administrative and clinical duties. Essential Duties And Responsibilities Reviewing client referral material, presenting referrals to assigned foster parent(s) able to accept client(s) as a placement, facilitating placement of said client(s) in a foster home by communicating with Program Director, referral source, and the foster parent(s). Marketing and building internal and external relationships with referral sources and foster parents. Providing families (foster, biological, or adoptive) with training and support needed to create a therapeutic environment in the home. Participating in the on-call process as assigned. Supporting fellow team members to ensure the best outcomes for all Clarvida clients and families. Completing documentation...