97 audit specialist jobs found

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....

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for Molina Healthcare. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice. Job Description Job Summary The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Contributes to overarching strategy to provide quality and cost-effective member care. This position will be supporting our Appeals and Grievances department. We are seeking a Registered...

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for Molina Healthcare. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice. Job Description Job Summary The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Contributes to overarching strategy to provide quality and cost-effective member care. This position will be supporting our Appeals and Grievances department. We are seeking a Registered...

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...

Compensation Pay Range: $10.70 - $16.70 The actual hourly rate will equal or exceed the required minimum wage applicable to the job location. Additional compensation includes annual, quarterly performance, or premiums may be paid in amounts ranging per hour in specific circumstances. Premiums may be based on schedule, facility, season, or specific work performed. Multiple premiums may apply if applicable criteria are met. The Installer Service Specialist is an experienced and technical parts specialist who services the needs of professional customers through the store’s installer counter. This position will oversee and direct the daily activity of the delivery specialist to ensure customers receive accurate and timely order deliveries. Bilingual candidates encouraged to apply. ESSENTIAL JOB FUNCTIONS Work with installers/professional customers to develop sales relationships. Quickly and accurately takes customer orders over the phone and online, invoice...

Location: 4910 Tiedeman Road, Brooklyn Ohio Location: Hybrid opportunity Hours: Monday- Friday from 8:30pm-5:00am Job Description We are seeking a detail-oriented Processing Specialist to support banking operations by managing and optimizing image-based workflows. This role focuses on processing, validating, and enhancing digital images for financial documents, ensuring accuracy, compliance, and efficiency in transaction processing. Strong 10 key skills are required. Job Summary Process and validate images of checks, payment documents, and other financial records using specialized imaging systems. Ensure compliance with Key Bank's banking standards, regulatory requirements, and security protocols. Optimize image quality for accurate data extraction and fraud description. Collaborate with operations and IT teams to troubleshoot imaging issues and improve workflows. Monitor system performance and recommend enhancements for speed and...

Job Description Oracle Health is transforming its development and regulatory processes to meet heightened FDA, MDR, and ISO 14155 standards and address ongoing patient safety, compliance, and product certification needs. As a clinical leader with patient safety and compliance expertise, you will provide organization-wide clinical leadership and strategic oversight, ensuring our product development teams integrate clinical context, manage patient safety risks, and maintain robust compliance across the entire portfolio-legacy and new. This role is essential in modernizing our clinical risk management and regulatory practices in partnership with AI-driven process improvements. Qualifications · Medical degree (MD, DO, or equivalent) required; board certification or clinical specialty training preferred. · Minimum 7 years' experience in clinical leadership roles within medical device, digital health, or regulated healthcare software sectors. · Extensive experience in...

Company Overview Airgas®, an Air Liquide company, is a leading supplier of industrial, medical, and specialty gases, as well as hardgoods and related products. With a global presence and a commitment to innovation, we serve over 1 million customers across various industries. Our mission is to provide reliable products and exceptional service that help our customers succeed. Airgas is Hiring for a Customer Support Specialist in Independence, OH! We are looking for you ! Pay: $20.75/hr Work schedule - Monday - Friday 8am-5:00pm Recruiter: Neelam Patel / neelam.patel@airgas.com / 917-751-3820 The Customer Support Specialist resolves customer account problems by researching, analyzing and communicating with customers and Airgas associates in all areas of the company to obtain the needed information to solve customer account issues. Customer Support Specialists also provide administrative support for the Credit & Collections Department of Airgas North...

Driven by integrity and united by the people-and-pet bond, we find strong purpose in the work we do and an even greater joy in those we get to work alongside. Together, we harness the expertise of our long-standing tradition of excellence to embrace possibility and continuously push to do what's never been done before in pet care. Discover your purpose and fuel your passions when you bring your love of pets to a team that prides itself on the power of togetherness-We are Proudly Connected. Purely Driven. Position Summary Introducing Nestlé Purina's new Williamsburg Township, Ohio, factory - just 30 miles east of Cincinnati. This world-class factory will be built from the ground up to produce a wide variety of some of the most trusted and beloved pet care brands in the U.S. Our passionate team in Williamsburg Township will work in an environment that values safety, the latest technology in manufacturing and a culture of learning. Help us write the next chapter of Purina's...

Position Title: Quality Improvement Specialist (HEDIS) Work Location: Columbus, OH, 43219 Assignment Duration: 4 Months Work Schedule: Standard 8-hour workday 8am start (0.5-1hr lunch) Work Arrangement: Onsite Position Summary: Support the development and maintenance of quality improvement related projects specific to HEDIS Hybrid Operations. The position exists to support the health plans in the clinical aspect of medical record review. Key Responsibilities: Train providers, health plans and staff in methodologies and tools of continuous quality improvement and HEDIS abstraction and over-read processes Provide clinical support to the medical record abstraction, over-read and audit processes Monitor performance on established contractual quality indicators. Analyze, track and trend results Prepare for and participate in meetings with various committees, state agencies, providers, health plans, vendors, and stakeholders Recommend, develop, and implement quality...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: Put your passion where it meets purpose! Evolent attracts some of the brightest minds in health care. Surround yourself with talented, driven colleagues who share a passion for...

The Senior Corporate Quality Specialist serves as a strategic partner in advancing Avient’s global quality systems and certifications. This role leads cross-functional initiatives to enhance system integrity, user experience, and compliance across Avient’s enterprise platforms. The Senior Specialist is accountable for the governance, optimization, and training of core quality processes, including ISO certifications, internal and external audits, and global metrics reporting. With a focus on continuous improvement and risk mitigation, this role supports both corporate and site-level quality excellence. Responsibilities Lead assessments of Avient’s global quality system effectiveness, including CAPA, internal auditing, document control, process control, raw material management, and lab testing protocols Serve as a primary liaison for external customer audits, ensuring readiness, documentation integrity, and timely resolution of findings Drive Avient’s central...

Thank you for considering a career at Ensemble Health Partners! Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a...

Job Title: HEDIS Specialist Job Description Support the development and maintenance of quality improvement related projects specific to HEDIS Hybrid Operations. This role exists to support health plans in the clinical aspect of medical record review. Responsibilities Train providers, health plans, and staff in methodologies and tools of continuous quality improvement and HEDIS abstraction and over-read processes. Provide clinical support to the medical record abstraction, over-read, and audit processes. Monitor performance on established contractual quality indicators. Analyze, track, and trend results. Prepare for and participate in meetings with various committees, state agencies, providers, health plans, vendors, and stakeholders. Recommend, develop, and implement quality performance improvement plans (PIPs) with management utilizing the PDSA model. Monitor and report PIPs progress through closure. Perform other duties as...

Thank you for considering a career at Ensemble Health Partners! Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a...

POSITION SUMMARY Vertiv is seeking a precision driven Sales Commissions Specialist to support the administration of our diverse commission plans. The analyst will contribute to core operational and commission-related functions through both independent initiatives and cross-functional collaboration. A strong emphasis is placed on partnering with leadership, internal stakeholders, and external partners to deliver best-in-class customer service and operational excellence. RESPONSIBILITIES Ensure the accurate and timely processing of monthly incentive payments for the sales organization Collaborate with Finance to align commission processing with payroll timelines and corporate policies. Support the design, implementation, and communication of new commission plans or updates to existing plans. Monitor, track, and help resolve commission dispute tickets in a timely manner. Maintain comprehensive documentation for commission processes, calculations, and policy...

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,...

Position Overview At PNC, our people are our greatest differentiator and competitive advantage in the markets we serve. We are all united in delivering the best experience for our customers. We work together each day to foster an inclusive workplace culture where all of our employees feel respected, valued and have an opportunity to contribute to the company's success. As a Lending Transaction Specialist within PNC's ABF Servicing organization, you will be based in Brecksville, OH, Dallas, TX, Kalamazoo, MI, or Pittsburgh, PA. This position is primarily based in a PNC location. Responsibilities require time in the office or in the field on a regular basis. Some responsibilities may be performed remotely, at manager's discretion. Lending Transaction Specialist is the highest frontline position within the line of business. They will help lead projects, help lead initiatives, must be able to assist and train others, and must be able to also reconcile their own work. They...

Job Title: Medical Coder (RHIT, RHIA, CCS, CCS-P, CPC) Location: Columbus OH 43215 Pay: $20.00- $21.50 per hour Scheduled Pay: Bi-Weekly Hours: 8:00am – 5:00pm Job Type: Full Time Benefits: Health, Dental, Vision, Life Insurance, and Short term disability after 90 days Ready to apply or have questions? Contact- Ashley Kruger Call/Text- 586-710-7947 Email- akruger@alinestaffing.com Medical Coder Duties and Responsibilities: Under general direction, assists in monitoring and analyzing policies and procedures to organize and implement an accurate and efficient ICD policy and system support program. Serves as a medical policy resource, analyst, and technical expert for ICD, CPT, HCPCS, and other coding systems. Ensures statewide incorporation of applicable coding policies and guidelines. Supports monitoring and analysis of ICD reports generated on agency systems for proper usage and code assignment. Assists the ICD Program Manager with identifying...

As a Senior Environmental, Health & Safety Specialist at Cleveland-Cliffs, your contributions will be visible all around you; the work we do here impacts people for generations to come. Ideal candidates enjoy modern, dynamic, supportive work environments and are looking for the freedom to take control of their career. Summary of Responsibilities: Maintain compliance with OSHA regulations, Cleveland-Cliffs safety standards and safety plan requirements. Provide technical updates as needed regarding upcoming changes in regulations. Foster positive working relationship with the United Steel Workers (USW) and plant safety teams. Implement improvements in plant and division safety programs to prevent and reduce injuries. Review and define regulatory required training. Coordinate regulatory inspections and required safety audits. Coordinate safety training for salaried, represented employees, and contractors. Coordinate investigations of accidents and nears misses. Audit...

Description The CD and EE Activities Specialist is an important role within the CRA Governance Team. This role will act as a Subject Matter Expert for Community Development (CD) Activities with a focus on Community Development Services and will partner with internal lines of business to qualify CD services for the bank's CRA exam. The position will also play a key role in driving business development strategy and execution within BMO's Commercial Banking team focused on companies owned and/or operated by individuals of underserved communities. The analyst will support relationship managers and leadership in identifying new business opportunities, analyzing market trends, preparing client presentations, and developing insights that advance equitable access to capital and advisory solutions. This role offers the opportunity to work at the intersection of finance, strategy, and community impact - helping strengthen BMO's mission to boldly grow the good in business and life....

Thank you for considering a career at Ensemble Health Partners! Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of...

Thank you for considering a career at Ensemble Health Partners! Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a...

The Metropolitan Sewer District (MSD) of Greater Cincinnati seeks a Safety Professional with a wide variety of experience in general or construction industry safety fields. Experience should encompass working to promote safe operations on job sites. The incumbent will assist with the management of several OSHA programs such as: Trenching and Excavation Fall Protection and Prevention Permit Required Confined Space Entry Walking Working Surfaces PPE Hearing Conservation Respiratory Protection Other safety programs as assigned. These programs may require certification that will be provided by MSD if not already obtained. Additionally, the employee will establish a field presence MSD’s operating divisions to provide safety guidance and minimize injuries. The incumbent will support these division by driving continuous improvement through reviewing and auditing site safety plans provided by contractors for OSHA compliance and performing site visits with MSD employees...