58 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....

Senior Risk Associate (Work from Home) Capital One, a Fortune 500 company and one of the nation's top 10 banks, offers a broad spectrum of financial products and services to consumers, small businesses and commercial clients. Our mission is to create one of the nation's great banks, and we have the necessary ingredients: a strong balance sheet, resilient businesses, a massive customer franchise, strong analytical capabilities, and great people. We nurture a work environment where people with a variety of thoughts, ideas and backgrounds, guided by our shared Values, come together to make Capital One a great company - and a great place to work. As a Senior Associate Quality Assurance Specialist at Capital One, you will be part of a smart, talented team responsible for partnering with Lines of Business across the Capital One footprint to ensure compliance with the Travel Rule. The qualified candidate will be responsible for sampling wire transactions across multiple...

DRG CODING AUDITOR Virtual **_:Â _** _Â _ ? 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. 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. The DRG CODING AUDITOR is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines 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...

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 (ICD-9/10CM, MS-DRG, AP-DRG, APR-DRG) Virtual:Â ** _Â _ 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...

Dodge Construction Network (Dodge) is searching for a Director of GTM Systems and Tools to join our team! This is a high-visibility opportunity that will be a critical part of our Revenue Operations team focused on optimizing all tools that support field enablement within in our GTM systems infrastructure. The ideal candidate has a consistent track record of implementing solutions to business problems in Salesforce and integrated solutions throughout our GTM tech stack, working with both internal and external partners. This position reports directly to the VP, Revenue Operations. Preferred Location This is a remote, home-office based position and candidates located in the continental United States will be considered. Travel Requirements Some travel is expected for this role. Essential Functions Oversee, manage, and optimize all systems and tools used by the sales, customer success and support teams Lead a team of systems admins and specialists to...

Dentsply Sirona is the world’s largest manufacturer of professional dental products and technologies, with a 130-year history of innovation and service to the dental industry and patients worldwide. Dentsply Sirona develops, manufactures, and markets a comprehensive solutions offering including dental and oral health products as well as other consumable medical devices under a strong portfolio of world class brands. Dentsply Sirona’s products provide innovative, high-quality and effective solutions to advance patient care and deliver better and safer dentistry. Dentsply Sirona’s global headquarters is located in Charlotte, North Carolina. The company’s shares are listed in the United States on NASDAQ under the symbol XRAY. This position is located in Johnson City which is the largest city in the Tri-Cities area, located in the north eastern region of Tennessee at the foothills of the Appalachian Mountains. The city is a growing metropolis with invigorating music, enchanting...

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...

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...

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 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...

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,...

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 Datavant. 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. Datavant is a data platform company and the world’s leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world’s leading life sciences companies, government agencies, and those who deliver and...

DESCRIPTION Overview The Associate is responsible for completing in-store food and non-food demonstrations. Acquires and maintains knowledge of products represented. Serves, demonstrates, intercepts consumers and sells products in a professional manner. Responsible for the Event execution equipment in the stores. Maintains an overall professional appearance consistent with the requirements of the job. Pay Rate $16.50-18.00/hour RESPONSIBILITIES Management and maintenance of the equipment and supplies used for events to ensure they are clean and secured in the agreed upon area of the backroom. When Supervisor is absent, communicate with store management about the upcoming events and the execution of past events in their store. When Supervisor is absent, be the point person for all events being conducted in the store. Assists other Event Specialists with event kits, materials and tools as needed. Assist Supervisor by always providing leadership...

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 $14.00/hour 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 professional...