69 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....

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...

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...

Overview Senior Risk Manager and Regulatory Specialist, Quality Managment Full Time, 80 Hours Per Pay Period, Day Shifts Cumberland Medical Center Overview: Cumberland Medical Centerin Crossville, Tennessee is part of Covenant Health, East Tennessee's largest nonprofit health system and a Becker's "Top 150 Places to Work in Healthcare." Fully accredited by the Joint Commission, Cumberland Medical Center is an acute care hospital offering all private patient rooms as well as comprehensive care including cardiology, orthopedics, maternity, cancer treatment, and wound care. The hospital features emergency and critical care, surgical suites, and specialized programs such as imaging, cardiac rehab, sleep disorder care, and hyperbaric medicine, all in a family-oriented environment focused on exceptional patient care. Position Summary: The Sr. Risk Manager and Regulatory Specialist position is responsible for planning, budgeting, monitoring, and evaluating performance...

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...

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...

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...

Title: Specialist, IT Purchasing-Inventory Department: Information Technology Number of Positions: 1 Classification: 3/On Campus Position #: 651140 Type of Appointment: Non-Exempt Pay Rate: $37,720 - $46,170/per year. Pay will be determined based on related work experience above required. To be considered in determining pay, all related work experience must be listed on the application. Required Documents Needed to Upload at Time of Application: Resume, transcripts and three professional references. Reference check requirements: Three (3) professional references, two (2) of which should be former or current supervisors and (1) professional reference. Personal references (friends, clergy, customers, relatives) are not considered acceptable references. A professional reference such as a previous or current co-worker may be used as one of the references. Position Summary: This position provides technical – clerical support for the entire Information...

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...

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....

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...

Job Title Specialist - Assessment & Accreditation Department Dean Education Salary $57,113 - $71,487; commensurate with experience Job Summary/Basic Function The Assessment and Accreditation Specialist provides administrative, technical, and analytical support for the College of Education’s assessment, reporting, survey administration, and accreditation processes. The position manages assessment systems, designs and administers surveys, collects and verifies data, and maintains documentation required for state and national accreditation. Serving as a College-wide resource, this role supports all programs and operational units in meeting assessment, reporting, and compliance expectations. The specialist ensures that data, evidence, and records are accurate, organized, and accessible to support continuous improvement, program review, and accreditation activities. Required Education Master’s degree; OR bachelor’s degree with a minimum of four (4) years of...

Overview Accounts Payable Specialist Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region's top-performing healthcare network with 10 hospitals (http://www.covenanthealth.com/hospitals/) , outpatient and specialty services (http://www.covenanthealth.com/services/) , and Covenant Medical Group (http://www.covenantmedicalgroup.org/) , our area's fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area's largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year. Covenant Health is the only healthcare system in East Tennessee to be named a Forbes "Best Employer" seven times. Position Summary: Performs centralized accounts payable services to all Covenant Health fully...

Job Title: Inventory Coordinator Job Description The Materials and Inventory Control Specialist collaborates closely with Distribution Center operations to optimize space and resource utilization, ensure accurate production reporting, and provide necessary training. This role serves as a liaison between Operations and other departments to correct system input or data errors, and develops job instructions and flowcharts to meet operational requirements. Responsibilities Identify storage and performance inefficiencies within the warehouse and work with warehouse leadership to implement solutions. Set up parts and manage part obsolescence and removal in both QAD and customer systems. Develop, monitor, and audit the Production Reporting Reconciliation Process for transfers, barcodes, scrap, and work center accuracy. Ensure QAD accuracy in capturing and transferring production information. Control QAD long-range forecasts, including family...

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 Title: Inventory AnalystJob Description The Materials and Inventory Control Specialist collaborates closely with Distribution Center operations to optimize space and resource utilization, ensure accurate production reporting, and provide necessary training. This role serves as a liaison between Operations and other departments to correct system input or data errors, and develops job instructions and flowcharts to meet operational requirements. Responsibilities Identify storage and performance inefficiencies within the warehouse and work with warehouse leadership to implement solutions. Set up parts and manage part obsolescence and removal in both QAD and customer systems. Develop, monitor, and audit the Production Reporting Reconciliation Process for transfers, barcodes, scrap, and work center accuracy. Ensure QAD accuracy in capturing and transferring production information. Control QAD long-range forecasts, including family forecasting....

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...

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...

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 Billing Specialist - Remote Job Description The Billing Specialist is responsible for ensuring the accuracy and completeness of billing data, supporting payment reconciliation processes, and maintaining thorough documentation of billing-related activities. This role plays a critical part in the financial operations of the organization by validating billing inputs, assisting with adjustments and re-billings, and ensuring all records are properly maintained for audit and reporting purposes. Responsibilities Validate billing data to ensure accuracy and completeness Assist in reconciling payments, adjustments, and re-billings Maintain detailed and organized documentation of billing, payment, and related...

POSITION SUMMARY: The Retail Internet Used Firearms Specialist position is responsible for creating accurate descriptions and capturing high-quality images of store selection of used firearms. This role uploads the used firearm selection descriptions and photographs for the used firearm online website. They maintain a high-quality website with accurate, up-to-date inventories. This position assists in making used firearm sales through customer interaction via e-mail, mail, telephone and personal contact. ESSENTIAL FUNCTIONS: Creates and uploads accurate descriptions and capture high-quality images of store selection of used firearms. Maintains a high-quality website with accurate, up-to-date inventories. Adds and deletes specific firearms as they are acquired, disposed, and transferred to keep the used firearm online inventory current and company expectations are met for percentage of guns maintained on company site per company direction. Evaluates and...