187 compliance auditor ii jobs found

PACS Group, Inc. is a holding company delivering post-acute healthcare services across the United States. The Clinical Compliance Auditor II conducts comprehensive audits of clinical documentation and reimbursement processes for Skilled Nursing Facilities and post-acute care settings, ensuring CMS and state compliance and supporting quality improvement initiatives. The role requires an active PT or OT license, a bachelor's degree, and 5+ years in compliance with oversight across multiple sites. #J-18808-Ljbffr

IEHP is seeking a Compliance Auditor II to conduct comprehensive audits across the Plan, ensuring adherence to Federal, State, and contract requirements. You will identify risks, draft findings, and develop corrective action plans, overseeing reviews of operations, policies, and processes. The role requires strong knowledge of California managed care regulations, excellent written and verbal communication, and the ability to operate with minimal supervision. Hybrid work options available. #J-18808-Ljbffr

What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! Role Overview The Compliance Auditor II conducts comprehensive audits and reviews across the Plan, including assigned areas and Plan delegates, to ensure adherence to Federal, State, and contractual regulatory requirements. Identifies and assesses risks impacting overall compliance, drafts detailed audit findings and actionable recommendations, and evaluates operations, policies, and processes throughout the Plan. Conducts evaluations of operations, policies, and processes to validate compliance, evaluate effectiveness, and identify issues. Issues corrective action plans and reviews for acceptance to ensure that all compliance issues are appropriately addressed. Performs validation audits to determine if actions have been taken to mitigate identified risks and conducts routine monitoring...

Baxter is seeking a Quality Associate II to navigate internal processes ensuring product safety and quality. You will manage audits, CAPAs, and regulatory readiness, mentoring teammates and driving compliant outcomes across Quality operations. The role emphasizes collaboration, data-driven decision making, and adherence to GMP standards while supporting inspections and regulatory intelligence efforts. #J-18808-Ljbffr

Baxter is seeking a Quality Associate II who thrives in a collaborative environment and can guide audits and compliance initiatives. You will navigate complex regulatory data, train peers, and drive timely CAPA execution while maintaining safety and quality as top priorities. The role involves leading audits, supporting inspections, and mentoring team members within the Quality organization, with a focus on continuous improvement and robust regulatory readiness. #J-18808-Ljbffr

University of Florida College of Medicine seeks a Compliance Audit Specialist II to perform regulatory audits across departments, ensuring data integrity and adherence to federal and state rules. The role collaborates with the Compliance Audit Specialist manager and Director of Physician Billing Compliance to develop training content and improve internal controls. Strong coding credentials and proficiency in MS Office are preferred. #J-18808-Ljbffr

FLHSMV in Tallahassee seeks an MS Compliance Officer II to review audits of licensees under IFTA and IRP, ensuring regulatory compliance and proper record keeping. The role requires analyzing audit reports, distance and fuel records, and coordinating communications with auditees during various stages of the process. The ideal candidate will have strong auditing skills, accounting knowledge, and the ability to clearly report findings. #J-18808-Ljbffr

If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered. Day - 08 Hour (United States of America) This is a Stanford Health Care job. A Brief Overview Billing and Coding Compliance Auditors conduct audits and monitoring activities to identify and address compliance risks related to billing and coding practices. They review and evaluate healthcare regulatory compliance, focusing on the detection of documentation, coding, and billing errors. Responsibilities include assessing the adequacy and accuracy of documentation supporting billed services, including ICD, CPT, HCPCS, and other third-party payer codes, as well as adherence to Teaching Physician guidelines, Evaluation & Management criteria, DRG and APC assignments, medical necessity, and reimbursement accuracy. Auditors serve as a communication channel, partnering with Billing and Coding...

Seminole Hard Rock Hotel & Casino Tampa is seeking an auditor to support compliance activities and daily audits. The role focuses on maintaining records, verifying revenues, and ensuring adherence to IC, Title 31 and PCI guidelines. Qualified candidates will have at least 1 year in computerized auditing/accounting or casino operations with strong MS Word/Excel skills. Weekend/holiday availability is required in a professional office setting near the casino floor. #J-18808-Ljbffr

Vitu, Inc. in Ohio is seeking an Auditor II to join our onsite team, supporting document management and release services. Under supervision, you’ll handle lender packets, validate and file documents, and ensure smooth workflow between departments. The role requires a high school diploma or GED, 3 years in a related field, and proficiency with Word and Excel. Strong attention to detail, teamwork, and the ability to work flexible shifts including overtime are essential. #J-18808-Ljbffr

Seminole Casino Hotel Immokalee in Immokalee, FL, is seeking a Revenue Verification Clerk to ensure accurate handling of cage, soft count, table games, slots, and hotel financial transactions. You will review taxable winnings for Title 31 compliance, generate daily reports such as Flash, DOR and deposits, and assist with account reconciliations. The role requires adherence to company policies, completion of required trainings, and collaboration with team members to maintain a secure, compliant #J-18808-Ljbffr

Stanford Health Care seeks a Billing and Coding Compliance Auditor to conduct proactive audits, review documentation for regulatory compliance, and collaborate across departments to mitigate risks. The role involves evaluating ICD, CPT, HCPCS codes and E/M criteria, with a focus on accuracy and reimbursement integrity. Requirements include an Associate’s degree and at least four years of related experience; professional coding certifications are preferred and must be obtained within 180 days. #J-18808-Ljbffr

A healthcare provider in Chicago is seeking a Compliance Auditor to perform audits on provider documentation and coding. Responsibilities include managing compliance issues and communicating effectively with providers regarding results. Candidates should have a Bachelor's Degree and relevant certifications like RHIA or CPC. Strong interpersonal skills and experience in healthcare compliance are preferred. This role offers competitive benefits and opportunities for professional growth. #J-18808-Ljbffr

Servpro Industries, LLC in Gallatin is seeking a Jr. Compliance Auditor to manage franchise audits and optimize processes. You will guide audit staff, provide training, and maintain quality standards while conducting audits. The ideal candidate should have 2+ years in franchise auditing or a related field and possess a Bachelor's degree in accounting. The role promises excellent benefits and a supportive work environment. #J-18808-Ljbffr

1.0 FTE Full time Day - 08 Hour R2658919 Remote USA 108610021 Admin Compliance Business & Administration Day - 08 Hour (United States of America) This is a Stanford Health Care job. A Brief Overview Billing and Coding Compliance Auditors conduct audits and monitoring activities to identify and address compliance risks related to billing and coding practices. They review and evaluate healthcare regulatory compliance, focusing on the detection of documentation, coding, and billing errors. Responsibilities include assessing the adequacy and accuracy of documentation supporting billed services, including ICD, CPT, HCPCS, and other third-party payer codes, as well as adherence to Teaching Physician guidelines, Evaluation & Management criteria, DRG and APC assignments, medical necessity, and reimbursement accuracy. Auditors serve as a communication channel, partnering with Billing and Coding Compliance Educators to address compliance issues. They are responsible for conducting...

Bilingual (Japanese-English) Compliance Auditor Lingua Science is recruiting for a direct hire position of bilingual (Japanese-English) Internal Compliance Auditor I or Internal Compliance Auditor II at a major automotive supplier in Novi, Michigan. Duties: Responsible for company assessing internal controls, risk, information security, and overall corporate governance for North American operations. Develop and implement audits to review internal compliance with laws, regulations, and industry standards, and verify adherence to corporate policies and ethical standards. Develop and implement audits to assess business operation efficiency and effectiveness. Assess the security of the company’s information systems, data, and technology infrastructure. Provide recommendations to optimize processes and productivity. Conduct reviews of operations to identify areas for improvement and cost savings. Coordinate with various groups for improvement activities and monitor progress. Create...

Inland Empire Health Plans is seeking a Compliance Auditor II to conduct comprehensive audits across the Plan, ensuring adherence to Federal, State, and contractual requirements. You will identify risks, draft findings, and recommend improvements to strengthen the control environment. The role involves evaluating operations and policies, issuing corrective action plans, and monitoring implementation while aligning with IEHP's quality initiatives like HEDIS, CAHPS, and NCQA Accreditation. #J-18808-Ljbffr

Salary Range: $88,854.00(Min.) -$115,509.00(Mid.) -$142,166.00(Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Financial Compliance Auditor III Finance is responsible for various tasks within the Financial Compliance Unit which include, but not limited to, performing, reporting, and corrective action plan monitoring of financial solvency reviews of plan partners, participating provider groups, capitated hospitals, specialty health plans, and...

Position Summary: Billing Compliance Auditor III (hybrid). Under general supervision performs audits of clinical documentation, physician billing and payment records and applicable industry standard codes by analyzing medical records, coding records and health system bills validating clinical documentation in conjunction with the bill; assessing the level and accuracy of coding, determining that governmental and third party payer regulations are being complied with; and evaluating appropriateness of billing and coding procedures. Evaluates accuracy and risk level of coding and billing performance by individuals and clinical units. Prepare reports and provide individual and/or group instruction to physicians and others based on results of audit. Works collaboratively with appropriate personnel to identify and recommend strategies for process improvement and to develop and draft billing and coding policies for the CHB Foundations in coordination with the Hospital. Assists in response...

L.A. Care Health Plan in Los Angeles is seeking a Financial Compliance Auditor III to lead financial solvency reviews across plan partners, providers, capitated hospitals and vendors. You will perform audits, analyses, and reporting under GAAP and DMHC/DHCS/CMS regulations, collaborating with management and stakeholders to resolve issues. The role requires strong communication, mentoring, and the ability to design and implement monitoring tools and procedures. Travel off-site may be required. #J-18808-Ljbffr

Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Financial Compliance Auditor III Claims is responsible for audits of claims processed by Delegated Participating Physician Groups (PPGs), hospitals and health plans contracted with L.A. Care and various tasks within the Financial Compliance Unit. This position works closely with management on identification and resolution of...

Financial Compliance Auditor III Claims Job Category: Accounting/Finance Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 13259 Salary Range: $88,854.00(Min.) -$115,509.00(Mid.) -$142,166.00(Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Financial Compliance Auditor III Claims is responsible for audits of claims processed by Delegated Participating Physician Groups (PPGs), hospitals and health plans contracted...

Select how often (in days) to receive an alert: Financial Compliance Auditor III Claims Job Category: Accounting/Finance Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 13259 Salary Range: $88,854.00(Min.) -$115,509.00(Mid.) -$142,166.00(Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low‑income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low‑income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Financial Compliance Auditor III Claims is responsible for audits of claims processed by Delegated Participating Physician...

Position Summary Billing Compliance Auditor III (hybrid). Under general supervision performs audits of clinical documentation, physician billing and payment records and applicable industry standard codes by analyzing medical records, coding records and health system bills validating clinical documentation in conjunction with the bill; assessing the level and accuracy of coding, determining that governmental and third party payer regulations are being complied with; and evaluating appropriateness of billing and coding procedures. Evaluates accuracy and risk level of coding and billing performance by individuals and clinical units. Prepare reports and provide individual and/or group instruction to physicians and others based on results of audit. Works collaboratively with appropriate personnel to identify and recommend strategies for process improvement and to develop and draft billing and coding policies for the CHB Foundations in coordination with the Hospital. Assists in response...