295 regulatory auditor supervisor jobs found

Job Location: This position will be located at 920 Wildwood Dr. Jefferson City, MO, in the Division of Regulation and Licensure. Why You’ll Love This Position Become a part of a collaborative team within the Division of Regulation and Licensure. This position serves as the Healthcare Support Programs Unit Supervisor and provides administrative oversight to: the Certificate of Need program, tasked with providing administrative support to the Missouri Health Facilities Review Committee and the Supplemental Health Care Agency program, tasked with the review of initial and annual renewal registration applications and collection of fees from agencies that provide nursing and other caregiving staff to long term care facilities and hospitals on a temporary, contractual basis. The salary indicated represents a base pay rate. If the individual selected or the position is eligible for a pay differential (e.g., shift, security, or years of service), it will be added to the total...

Missouri Department of Health and Senior Services in Jefferson City seeks a Healthcare Support Programs Unit Supervisor within the Division of Regulation and Licensure. You will provide administrative oversight to the Certificate of Need program and to the Supplemental Health Care Agency program, including registration applications and fee collection from agencies supplying nursing and other staff to facilities. #J-18808-Ljbffr

WellStreet Urgent Care is redefining the urgent care experience through patient-focused service, high-quality care, and strong partnerships with health systems. As a rapidly growing healthcare organization, we are building a national network of urgent care facilities and creating opportunities for talented professionals to make a meaningful impact. If you’re an experienced medical coder who enjoys digging into documentation, identifying coding opportunities, and helping providers and coding teams improve accuracy, this could be a great opportunity to join our team. About the Role The Professional Coding Auditor reviews clinical documentation and coding to ensure accuracy, completeness, compliance, appropriate charge capture, and alignment between documentation and assigned CPT and ICD-10 codes. This role goes beyond identifying errors—you’ll help educate providers and coders, identify trends, and partner with leadership to improve coding quality and reimbursement. What You’ll...

Job Description Job Description Position Summary: The Medical Coding Auditor conducts audits to provide investigative support related to potential fraud, waste, abuse and/or overpayment. Through pre and post payment medical records review and appeal records review, the Medical Coding Auditor ensures appropriate coding on claims paid and maintains compliance documentation of any fraud, waste or abuse identified based on coding guidelines, coverage policies and regulatory and contract requirements. Qualifications:  Medical Coder certification from accredited source (e.g. American Health Information Management Association, American Academy of Professional Coders or Practice Management Institute) required. Prior experience in Medicaid claims role and/or post payment medical coding auditor role preferred. Knowledge of Medicaid rules, claims processing, medical terminology and coding principles and practices. Knowledge of auditing, investigation, and research. Knowledge of...

Looking for an opportunity to make an impact? At Leidos, we deliver innovative solutions through the efforts of our diverse and talented people who are dedicated to our customers’ success. We empower our teams, contribute to our communities, and operate sustainable. Everything we do is built on a commitment to do the right thing for our customers, our people, and our community. Our Mission, Vision, and Values guide the way we do business. Your greatest work is ahead! Leidos’ Defense Sector Mission Assurance is seeking a Lead Compliance Auditor to join our team and serve as the senior technical authority for audit execution across our manufacturing and production operations. The Lead Compliance Auditor plans, leads, and reports internal quality and compliance audits, owns the Layered Process Audit (LPA) program on the production floor, and verifies conformance to customer, contractual, governmental, and industry standards including ISO 9001, AS9100, CMMC, DFARS, ITAR, FAR, and...

JOB SUMMARY: The Risk Adjustment Auditor is responsible for reviewing medical records and related documentation to ensure accurate capture of diagnoses in compliance with CMS risk adjustment guidelines and ICD-10-CM coding standards. This role plays a critical part in supporting accurate risk score calculation, regulatory compliance, and overall program integrity. KEY RESPONSIBILITIES: Perform bi-directional retrospective and prospective medical record reviews to validate, clarify, and accurately capture risk adjusted diagnoses (HCCs) in accordance with CMS guidelines and MEAT documentation requirements. Ensure documentation supports coded conditions in accordance with ICD-10-CM, CMS, and payer-specific guidelines. Identify unsupported diagnoses, over coding, under-coding, and documentation gaps. Provide detailed audit findings and recommendations to coding teams, providers, and leadership. Monitor compliance with CMS Risk Adjustment Data Validation (RADV) standards. Track and...

Job Description Job Description Must reside in the following states:  AZ, CT, DE, FL, GA, IL, IN, KS, MA, MD, ME, MI, MS, NC, NH, NJ, NY, OH, OK, PA, SC, TN, TX, and VA   Northwell is the largest not-for-profit health system in the Northeast, serving residents of New York and Connecticut with 28 hospitals, more than 1,000 outpatient facilities, 22,000 nurses and over 20,000 physicians. Northwell cares for more than three million people annually in the New York metro area, including Long Island, the Hudson Valley, Connecticut and beyond, thanks to philanthropic support from our communities. Northwell is New York State’s largest private employer with over 104,000 employees — including members of Northwell Health Physician Partners — who are working to change health care for the better.  Summary: Purpose: Provides clinician practice coding, billing, and documentation auditing for professional coding at Nuvance Health. Conducts routine quality assurance (QA) audits on...

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 ClaimsJob Category: Accounting/Finance Department: Financial Compliance Location: Los Angeles, CA, US, 90017 Position Type: Full Time Salary Range: $88,854.00 (Min.) - $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....

Professional Coding AuditorWellStreet Urgent Care is redefining the urgent care experience through patient-focused service, high-quality care, and strong partnerships with health systems. As a rapidly growing healthcare organization, we are building a national network of urgent care facilities and creating opportunities for talented professionals to make a meaningful impact.If you're an experienced medical coder who enjoys digging into documentation, identifying coding opportunities, and helping providers and coding teams improve accuracy, this could be a great opportunity to join our team.The Professional Coding Auditor reviews clinical documentation and coding to ensure accuracy, completeness, compliance, appropriate charge capture, and alignment between documentation and assigned CPT and ICD-10 codes. This role goes beyond identifying errors—you'll help educate providers and coders, identify trends, and partner with leadership to improve coding quality and reimbursement.What...

Coding Compliance Auditor/EducatorTitle: Coding Compliance Auditor/Educator Location: Fountain Valley/Predominantly Remote (Must reside in CA) Department: Document Improvement Status: Per Diem Shift: Day Pay Range*: $50.00/hrMemorialCare is a nonprofit integrated health system that includes four leading hospitals, award-winning medical groups – consisting of over 200 sites of care, and more than 2,000 physicians throughout Orange and Los Angeles Counties. We are committed to increasing access to patient-centric, affordable, and high-quality healthcare; your personal contributions are integral to MemorialCare's recognition as a market leader and innovator in value-based and other care models. Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration, and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve...

Overview Certified Medical Coder required (AHIMA, AAPC, or PMI). Hybrid-Sunrise, Florida The Medical Coding Auditor conducts audits to provide investigative support related to potential fraud, waste, abuse and/or overpayment. Through post payment medical records review, the Medical Coding Auditor ensures appropriate coding on claims paid and maintains compliance documentation of any fraud, waste or abuse identified based on coding guidelines and regulatory and contract requirements. Essential Duties and Responsibilities Performs post payment medical record review audits of claims payments to identify potential fraud, waste, abuse and/or overpayment. Completes and maintains detailed documentation of audits including but not limited to coding guidelines reviewed, medical necessity documentation, decision methodology, and monetary discrepancies identified. Coordinates overpayment recoveries with the Fraud Investigative Unit Manager. Responsible for assisting the Fraud Investigative...

Basic Function HF Sinclair Midstream is seeking a Compliance Auditor Lead. The position is open to Dallas, TX; Tulsa, OK; Artesia, NM or Salt Lake City, UT. The Compliance Auditor Lead ensures compliance with regulations and conducts moderate to complex regulatory compliance and auditing assignments for assigned areas under general supervision. Job Duties Reviews, interprets, and ensures compliance with applicable federal, state, and local regulatory requirements for all assigned locations. Plans, conducts, and leads regulatory compliance and operational risk‑based audits, including evaluations and review of internal policies and procedures of the company operations. Serves as the primary liaison to regulatory agencies and as the Company's point of contact for general inquiries, audits, and on‑site evaluations. Leads and coordinates follow‑up activities associated with regulatory inspections, audits, and enforcement actions by tracking corrective actions, conducting gap...

Senior Compliance Auditor, Management Analyst 5 Full Time, PermanentWe are excited to announce a wonderful opportunity for an internal or external auditing professional. We are now accepting applications for our Senior Compliance Auditor, Management Analyst 5, Full-Time Permanent position, located in scenic Port Orchard, Washington. In this position you will report directly to the WDVA Internal Audit & Compliance Manager. While this position is not a supervisory role, it is responsible for leading other Compliance Auditors in projects, assigning and reviewing work, providing feedback and guidance, under the direction of the WDVA Internal Audit & Compliance Manager. Standard business hours are Monday through Friday, 8:00 am to 5:00 pm. A flexible schedule may be possible depending on workload and business needs, as approved by the supervisor. Work is conducted primarily in a skilled nursing facility and occasionally in other agency offices. This position is authorized...

45225BR Medical Coding Supervisor Centralized Coding Lbk Lubbock Introduction Nationally recognized as a Great College to Work For , TTUHSC provides much more than just a job! Enjoy excellent benefits , including paid leave, retirement plans, wellness programs, health insurance and so much more. Ready to start building a rewarding career in a positive environment where you can develop and thrive? About TTUHSC Texas Tech University Health Sciences Center is enriching the lives of others by educating students, providing excellent patient care, and advancing knowledge through innovative research. TTUHSC graduates more health care professionals than any other health care institution in the state, conferring 24.2% of all degrees and certificates awarded from health-related institutions in Texas. By providing comprehensive clinical services to more than 10 million individuals across 121 counties, TTUHSC is dedicated to advancing the health of people throughout Texas and beyond....

Newrest is seeking a Transportation Safety Auditor Supervisor based at the airport. You will oversee the safety auditor team, train staff, and audit all safety processes to ensure regulatory compliance and safe operations across the ramp and vehicle fleet. You will perform routine ramp safety checks, handle incident investigations, and maintain detailed audit records. A valid driver's license and English proficiency are required for day-to-day duties. #J-18808-Ljbffr

Location: Salt Lake City, Utah, United StatesCompany: NewrestPosted: 2026-09-10Newrest is seeking a Transportation Safety Auditor Supervisor based at the airport. You will oversee the safety auditor team, train staff, and audit all safety processes to ensure regulatory compliance and safe operations across the ramp and vehicle fleet.You will perform routine ramp safety checks, handle incident investigations, and maintain detailed audit records. A valid driver's license and English proficiency are required for day-to-day duties.#J-18808-Ljbffr

JOB SUMMARY:The Risk Adjustment Auditor is responsible for reviewing medical records and related documentation to ensure accurate capture of diagnoses in compliance with CMS risk adjustment guidelines and ICD-10-CM coding standards. This role plays a critical part in supporting accurate risk score calculation, regulatory compliance, and overall program integrity.KEY RESPONSIBILITIES:•    Perform bi-directional retrospective and prospective medical record reviews to validate, clarify, and accurately capture risk adjusted diagnoses (HCCs) in accordance with CMS guidelines and MEAT documentation requirements.•    Ensure documentation supports coded conditions in accordance with ICD-10-CM, CMS, and payer-specific guidelines.•    Identify unsupported diagnoses, over coding, under-coding, and documentation gaps.•    Provide detailed audit findings and recommendations to coding teams, providers, and leadership.•    Monitor compliance with CMS Risk Adjustment Data Validation (RADV)...

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...

Location: Tulsa, Oklahoma, United StatesCompany: CommUnityCarePosted: 2026-09-08JOB SUMMARY:The Risk Adjustment Auditor is responsible for reviewing medical records and related documentation to ensure accurate capture of diagnoses in compliance with CMS risk adjustment guidelines and ICD-10-CM coding standards. This role plays a critical part in supporting accurate risk score calculation, regulatory compliance, and overall program integrity. KEY RESPONSIBILITIES:• Perform bi-directional retrospective and prospective medical record reviews to validate, clarify, and accurately capture risk adjusted diagnoses (HCCs) in accordance with CMS guidelines and MEAT documentation requirements. • Ensure documentation supports coded conditions in accordance with ICD-10-CM, CMS, and payer-specific guidelines. • Identify unsupported diagnoses, over coding, under-coding, and documentation gaps. • Provide detailed audit findings and recommendations to coding teams, providers, and leadership. •...

Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the "12 Angry Seniors." Their mission continues to guide everything we do. Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults. Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models. Across all of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with integrity. At SCAN, we believe...

Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the “12 Angry Seniors.” Their mission continues to guide everything we do. Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults. Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models. Across all of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with integrity. At SCAN, we believe...

Quality Management Systems Supervisor Job Summary The Quality Management Systems Supervisor will oversee the development, implementation, and maintenance of the organization’s Quality Management System (QMS) to ensure compliance with industry regulations and standards (ISO 9001, ISO 13485, AS9100). Reporting to the Director of Quality Affairs, this individual will drive continuous improvement, support and lead internal/external audits, manage CAPA processes, and provide cross‑functional training to enhance quality awareness. Key Responsibilities Manage the QMS structure, ensuring all policies, procedures, and Work Instructions (SOPs) are compliant with regulatory requirements and align with company strategic goals. Lead both internal and external audits (customer, registrar, regulatory), coordinate audit finding responses, and verify the effectiveness of corrective actions. Lead root cause analysis (RCA) for non‑conformances, customer complaints, and deviations, implementing...

Looking for an opportunity to make an impact? At Leidos, we deliver innovative solutions through the efforts of our diverse and talented people who are dedicated to our customers’ success. We empower our teams, contribute to our communities, and operate sustainable. Everything we do is built on a commitment to do the right thing for our customers, our people, and our community. Our Mission, Vision, and Values guide the way we do business. Your greatest work is ahead! Leidos’ Defense Sector Mission Assurance is seeking a Lead Compliance Auditor to join our team and serve as the senior technical authority for audit execution across our manufacturing and production operations. The Lead Compliance Auditor plans, leads, and reports internal quality and compliance audits, owns the Layered Process Audit (LPA) program on the production floor, and verifies conformance to customer, contractual, governmental, and industry standards including ISO 9001, AS9100, CMMC, DFARS, ITAR, FAR, and...