65 auditor jobs found

Healthcare Compliance AuditorEmpowering Wellness, Transforming LivesOptima Medical Management Group is dedicated to enhancing the quality of life by promoting wellness. At Optima MMG and all of its divisions: Serene Health, Community Support, and American TrueCare, our mission is to provide comprehensive support and care that not only addresses immediate concerns but also fosters long-term well-being.As pioneers in the field, we aspire to lead in member care outcomes and set new standards for excellence and innovation. We are committed to empowering our members to achieve self-sufficiency in health, creating a ripple effect that strengthens families and communities.Our work culture at Optima MMG is built on pride, passion, and a collective commitment to making a positive difference in people's lives. Our team members are dedicated problem-solvers who bring their unique skills and perspectives to the table. We believe that by fostering a collaborative and supportive environment, we...

Quality Assurance Coder/Auditor The Quality Assurance Coder/Auditor will develop a risk mitigation and provider education program. On a regular basis, Coder/Auditor will educate primary care providers and their staff on their historical diagnoses/coding error trends, accurate completion of medical record documentation, and at-risk code identification and risk mitigation. This includes the review, analysis, and recommended coding based on medical and clinical diagnoses, procedures, injuries, or illnesses contained in medical records and supporting documentation. The Quality Assurance Coder/Auditor will perform risk mitigation analysis using available vendor tools to identify at-risk single occurrence of HCCs and OIG targets. Deletions will be submitted for unsupported/invalid diagnoses. This analysis combined with QA findings and EDPS claims errors will drive the content and audience for provider education. The Quality Assurance Coder/Auditor will perform medical record reviews...

Research Compliance Auditor Position Highlights The Human Subjects Protection Program (HSPP) provides administrative and regulatory support to the University of Arizona Institutional Review Board (IRB). Through collaboration with the research community, the HSPP promotes ethical and compliant human research. The HSPP is seeking a Research Compliance Auditor who will primarily conduct routine audits of research protocols for adherence to federal, state and institutional policy. The Research Compliance Auditor will collaborate with the Quality Assurance officer and a varied group of auditors across multiple departments to ensure a broad cross-section of research projects are reviewed. They will identify mitigation strategies through analysis of corrective actions which increase adherence to policy, and are identified by compliance committees in the research division. The Research Compliance Auditor will assist with development of tools and resources to assist investigators regarding...

The University of Arizona is seeking a Research Compliance Auditor within the Human Subjects Protection Program (HSPP) to audit research protocols for adherence to federal, state and institutional policies. You will collaborate with Quality Assurance and other auditors, develop tools for regulatory submissions, and help investigators understand regulatory requirements while supporting investigations led by the AVP Regulatory Affairs. #J-18808-Ljbffr

Become a part of our caring community The Medical Coder extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coder assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters, and manipulates databases. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Review medical documentation for clinical indicators to ensure correct...

Phoenix Children's in Phoenix, AZ is seeking a Coding Auditor and Educator under the supervision of the Manager of Professional Services. The role provides oversight on education and audits of medical records for compliance with federal coding regulations and guidelines (CPT, ICD-10, EM) to align with government and hospital billing requirements. You will audit ambulatory medical records, educate coders and providers to improve accuracy and compliance, maintain policy documents, and collaborate #J-18808-Ljbffr

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and identify opportunities for...

Job Description Job Description Job Title: Medical Auditor Job Type: Contractor Location: Remote Job Overview We are seeking experienced Medical Auditors to contribute their specialized expertise to an innovative healthcare AI project. In this role, you will help improve next-generation AI systems by reviewing, evaluating, and refining medical coding and audit-related content. This opportunity is ideal for professionals with strong experience in outpatient professional fee coding, auditing, and academic medical center environments. No prior AI experience is required—your healthcare expertise is what matters most. Key Responsibilities Conduct detailed reviews and audits of outpatient professional fee coding records for accuracy, compliance, and quality. Identify coding trends, gaps, risks, and opportunities for improvement. Evaluate audit findings using knowledge of academic medical center protocols and industry best practices. Document audit results and...

University of Arizona is seeking a Research Compliance Auditor at Tucson Campus to conduct routine audits of research protocols for adherence to federal, state, and institutional policy. You will collaborate with the QA officer and auditors across departments to ensure comprehensive review of diverse projects and develop mitigation strategies enhancing policy adherence. The role involves drafting audit reports, supporting regulatory submissions, and training investigators on compliance #J-18808-Ljbffr

Baylor Scott & White Health in Phoenix is seeking a Coding Auditor 1 to perform coding quality audits using ICD-10-CM/PCS, HCPCS, CPT and related references to support accurate classification and reimbursement. You will collaborate with Clinical Documentation Specialists, provide constructive feedback, and help ensure compliant documentation across internal teams and third-party vendors. A strong knowledge of coding rules and HIPAA is essential. #J-18808-Ljbffr

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note: Benefits may vary based upon position type and/or level. Job...

ARIZONA DEPARTMENT OF HOUSING is seeking an Office of Manufactured Housing Auditor/Investigator in Phoenix, AZ. The role focuses on post-production audits and inspections of manufactured housing to ensure retailer compliance with HUD and state regulations. Some remote work within Arizona may be available based on business needs. Responsibilities include conducting inspections, evaluating records, and investigating consumer complaints while coordinating with licensing authorities and local #J-18808-Ljbffr

Centriaautism is seeking a Clinical Compliance and Operations Auditor to ensure operational and clinical integrity across centers. This role involves conducting surprise audits, preparing staff for external reviews, and generating detailed reports to inform leadership. The ideal candidate will have a Master's degree, BCBA certification, and over 10 years of experience in clinical compliance. Proficiency in MS and G Suite is necessary, with expectations of up to 80% travel within Arizona. #J-18808-Ljbffr

About Optima Medical :Optima Medical is an Arizona-based medical group consisting of 30 locations and over 130medical providers, who care for more than 200,000 patients statewide.Our mission is to improve the quality of life throughout Arizona by helping communities Live Better, Live Longer through personalized healthcare, with a focus on preventing the nation's top leading causes of death.We go beyond primary care with a full spectrum of services including cardiovascular health services, behavioral health, allergy testing and immunotherapy, in-house lab testing, imaging, chronic disease management, and other specialty health services.We aspire to aid the growth of our company by welcoming the most qualified and deserving candidates aboard.This position requires an initial 60-day training period at our corporate office in Scottsdale, Arizona.Upon successful completion of training, the position will transition to a fully remote role.Job Responsibilities :Audit Medical Records...

Under direct supervision of the Manager of Professional Services, performs functions as both coding auditor and educator and is responsible for providing oversight on education and audits of medical records for compliance with federal coding regulation and guidelines. This position is responsible for the coordination of auditing and education in support of achieving organizational strategic initiatives. The position has a shared responsibility to assist in achieving teams goals. Uses knowledge of Phoenix Children's policies and procedures to provide a second level review of all Codes (CPT, EM, ICD-10 etc.) to achieve and maintain compatibility with Government and Phoenix Children's billing requirements and compliance standards. This position also assists with coding production as needed; reviews and resolves coding issues related to billing, researches complex coding issues, and participates in process improvements related to coding and EM management. Position Duties Ensures...

CVS Health is seeking a Program Integrity Auditor to review medical, behavioral health, transportation and other provider records, ensuring correct coding and documentation and adherence to regulatory standards. You will audit across Medicaid lines, identify FWA patterns, educate providers, and support regulator submissions while maintaining compliance with policies. Strong analytical skills and collaboration are essential. #J-18808-Ljbffr

A cleanroom technology provider in Phoenix, Arizona is seeking an AMC Auditor responsible for servicing client mechanical teams and ensuring AMC quality control. The role involves monitoring data, conducting audits, and supporting cleanroom operations. Candidates should have a high school diploma, strong communication skills, and the ability to follow procedures. The work environment includes construction sites with various challenges. Flexibility in scheduling is required, including potential overtime and weekend work. #J-18808-Ljbffr

CVS Health is looking for a Program Integrity Auditor in Phoenix, Arizona. This role involves reviewing medical records to ensure compliance with coding standards and identifying any fraudulent activities. Candidates should have 3-5 years of experience in claims data, be knowledgeable in coding guidelines, and hold an active CPC, CCS, or CPMA license. The ideal applicant will have strong analytical skills and the ability to work independently as well as collaboratively. This full-time position offers a competitive salary and a comprehensive benefits package. #J-18808-Ljbffr

Quadris Team, LLC - A Revenue Cycle Management Group, is searching for a dynamic person to join us, working with our highly skilled Medical Coding Team to fill the role of Medical Coding Auditor & Educator.We are a 100% remote team supporting our clients across the United States! See us at.The ideal applicant will be a subject matter expert in both Facility and Profee medical coding auditing.Job Focus :The Senior Coding Auditor may be responsible for a variety of duties and obligations, depending on the client and assignment.These responsibilities may include inpatient / outpatient / professional fee facility auditing, denial management, coding, implementation specialist, job aid creation, training, and specialty coding.The position may also be responsible for management of the audit team and project management.All coding and auditing are performed within the scope of regulatory and compliance law expectations.Auditing Responsibilities :May include conducting inpatient,...

Description At BLS, we pride ourselves on providing high-quality financial services with a focus on supporting our clients’ unique needs. We are currently seeking an experienced Employee Benefit Plan Accountant to join our growing team. This position offers the opportunity to work with a dynamic group of professionals in an engaging and fast-paced environment. Job Responsibilities: Assist in the preparation and review of financial statements of employee benefit plans (including defined contribution (401(k), 403(b), etc.), defined benefit, and health & welfare plans) Assist in the preparation of Form 5500 and related filings Manage the audits of employee benefit plans and coordinate with clients and their service providers Ensure compliance with ERISA regulations and other applicable laws Perform related testing procedures including reconciliation of reports, analysis of certifications and trust reports, sample selection procedures, participant data, contribution,...

Location: Casa Grande, Arizona, United StatesCompany: AbbottPosted: 2026-08-11Abbott in Casa Grande, AZ, is hiring a Compliance Specialist responsible for maintaining quality management systems and conducting audits. The role entails ensuring compliance with laws and regulations and managing food safety programs.This position requires a Bachelor's degree in a relevant field and a minimum of 2 years of experience in food manufacturing or pharmaceuticals. Abbott offers competitive compensation and benefits, fostering a culture of growth and innovation.#J-18808-Ljbffr

Abbott in Casa Grande, AZ, is hiring a Compliance Specialist responsible for maintaining quality management systems and conducting audits. The role entails ensuring compliance with laws and regulations and managing food safety programs. This position requires a Bachelor's degree in a relevant field and a minimum of 2 years of experience in food manufacturing or pharmaceuticals. Abbott offers competitive compensation and benefits, fostering a culture of growth and innovation. #J-18808-Ljbffr

SGI Global, LLC in Phoenix, Arizona is seeking a qualified Junior Compliance Officer to assist a federal law enforcement client with I-9 audit and compliance activities. The role is ideal for early-career professionals interested in employment eligibility verification and investigative support. This position requires an on-site schedule at government facilities during core business hours. Candidates should have a relevant degree and experience in compliance or audit processes. A strong emphasis on teamwork and adherence to government protocols is essential. #J-18808-Ljbffr

Sunset Health in Yuma, AZ, seeks a pharmacy compliance professional to support 340B programs and related compliance initiatives. You will assist leadership with system updates, verify 340B eligibility and pricing, and ensure correct billing with wholesalers and TPAs, while training staff on compliance procedures. The role involves collaboration across departments to maintain compliance and accurate financial records in a fast-paced clinical setting. #J-18808-Ljbffr