Auditor

• Examination and evaluation of the adequacy and effectiveness of the organization's system of internal control and the quality of performance in carrying out assigned responsibilities including:
• Assists Management with the Company’s ongoing compliance with the Sarbanes-Oxley Act by performing testing and documentation of controls.
• This includes participating in the preparation of the annual scoping document.
• Reviewing the reliability and integrity of financial and operating information and the means used to identify, measure, classify and report such information.
• Reviewing the systems established to ensure compliance with policies and procedures, in addition to laws and regulations, which could have a significant impact on operations and reports and should determine whether the organization is in compliance.
• Reviewing the means of safeguarding assets and, as appropriate, verify the existence of such assets.
• Reviewing operations or programs to ascertain whether results are consistent with established objectives and goals and whether the operations or programs are being carried out as planned
• Assist in the preparation of the annual audit plan.
• Plan and schedule assignments, ensuring completion within the budgeted hours and by the indicated deadline.
• Document/update written documentation of the systems of internal control using flowcharts and narratives.
• This is accomplished through interviews of employees, observation of procedures and examination of documentation
• Identify control weaknesses and exceptions to control procedures.
• Observe periodic physical inventories. These are performed on-site, at the warehouses and outside propane tank locations.
• Perform special projects as required. This may include analytical reviews, determination of operational efficiencies, fraud investigations and evaluation of newly acquired companies.
• Assist external auditors, as required
• Interview personnel to ascertain the procedures and controls in effect and to carry out testing.
• Document audit work thoroughly in written audit workpapers, using department-approved format.
• Conduct exit interview with management personnel at the conclusion of the audit to present audit findings.
• Prepare clear and comprehensive written reports on the results of the audit recommendations to improve control structure, and management corrective action plan

Internal Auditor II

• Conduct virtual audits of selected commercial lines policies by reviewing the customer’s business operations, including examining, verifying, and recording pertinent classification-related data from financial business records.
• Ensure quality of the audit through proper risk classification and exposure basis identification.
• Utilize laptop computer to record audit information provided by the Premium Audit Service Representative and to transmit completed audits in a timely manner.
• Discuss issues and problems with insureds to ensure understanding of the change in premium and to maintain good customer relations.
• Provide external customers (i.e., agents and insured’s) and internal customers (i.e., underwriting, claims, and accounting) with information to assist in their understanding of audit-related matters, including audit statements, procedures, and worksheets.
• Remain informed of changes and current information relative to premium auditing through discussions with industry experts and review of industry related literature.
• Exhibit excellent time management skills and can work from a home office with minimal direct supervision.
• Conduct business in a professional manner to conserve and protect the corporate assets of Builders Mutual.
• Work on special projects and assignments as required, in addition to regularly scheduled work.
• Share information and experiences with less experienced virtual premium auditors.

Premium Auditor

• Conduct independent appraisals of quality and compliance systems within technically advanced manufacturing settings
• Performs complex and demanding domestic and international (subject to experience) audits of suppliers of raw materials, packaging components, drug substance or other process intermediates, and finished drug products, or contracted services
• Audits are conducted in accordance with cGMP´s, ISO Standards, IPEC, ICH Q7A and company procedures
• Plans, coordinates and conducts scheduled or unscheduled cGMP audits of complex internal AstraZeneca Operational departments to ensure compliance to CGMP´s and AstraZeneca standards
• Provide clear and scientifically/technically justified interpretations and support for any audit findings and proposed corrective and preventive actions
• Liaise directly with local AZ and/or regional and global senior management, where necessary, to ensure issues are understood and proposed actions are acceptable
• Interpret and apply cGMP regulations and expectations
• Develop and interpret audits findings across the scope of the Global Quality Audit (GQA) in order to communicate trends and provide recommendations to address such developing trends in a proactive manner

Senior Auditor, Cell Therapy Quality

• Travelling to domestic, international, major program, and/or subsidiary company locations to perform audits of Northrop Grumman programs with other Internal Audit teammates.
• Performing audit procedures to review program related business functions such as: Program planning, scheduling, and control, in both fully compliant and tailored Earned Value Management (EVM) implementations.
• Substantiation of financial EAC update, reporting and recording with substantiation and reserves assessment, when required.
• Supplier management, including supplier performance reporting and management and contract requirements flowdown.
• Risk and Opportunity Management process and incorporation into Financial EACs.
• Management reporting of program data both internally and externally.
• Ensuring proper recording of transactions and compliance with applicable company policies/procedures, related contracts/agreements, and applicable laws.

Principal Auditor

• Supports Payment Integrity & Behavioral Health.
• Examines claims for compliance with relevant billing and processing guidelines and identifies opportunities for fraud and abuse prevention and control.
• Reviews and conducts analysis of claims and medical records prior to payment and uses required systems/tools to accurately document determinations.
• Researches new healthcare related questions as necessary to aid in investigations.
• Collaborates with the Special Investigation Unit and other internal areas on matters of mutual concern.
• Recommends possible interventions for loss control and risk avoidance based on the outcome of the investigation.
• Assists with training of new associates.

Clinical Provider Auditor II – Behavioral Health

• Conduct insurance premium audits for Workers Compensation, General Liability, and Automobile policies by auditing policyholder’s records, and applying manual rules and company standards
• Prepare for the audit by identifying the necessary information and type of records needed
• Prepare schedule to maximize optimal use of time
• Correspond with insured via phone, email and mail to setup audit appointments
• Examine the policyholder’s records, gather data to determine correct classifications for business activities and write an effective description of operations
• Prepare complete audit document, explain results to insured and communicate the results to the home office
• Travel to multiple audit locations
• Hybrid position - work from home and complete remote audits 2-3 days per week

• leads day-to-day activities of the audit team
• provides allocation of resources
• establishes priorities
• manages vendor relationships
• periodically audits work of vendors
• conducts provider meetings to discuss audit findings
• negotiates settlements
• researches claims payment methodologies
• prepares and analyzes reports on recoveries

Clinical Provider Auditor Lead – Behavioral Health

• Supports codes from final surgical/procedural operative reports signed by the provider.
• Reviews the complex (problematic coding that needs research and reference checking) medical records, ensures documentation is supported.
• Works with ModMed to ensure that the correct plans are used, modifiers attached and diagnosis attached.
• Audits provider medical records and charges for compliance with coding and documentation standards to ensure compliance with internal and government regulations.
• Provides continuing review and education of physician and ACPs to ensure appropriate level of care is reported.
• Partner with practices to review findings of the periodic chart review.
• Maintains a thorough understanding of anatomy and physiology, medical terminology, disease processes and surgical techniques through participation in continuing education programs to effectively apply ICD-10-CM and CPT coding guidelines to diagnoses and procedures in offices.
• Correlates information supporting clinical documentation not limited to Pathology, Radiology and/or other Physician Consultations after review by the Attending Physician, wherever appropriate.
• Regularly meets with physicians and ACPs to provide continuous education on billable services, medical record documentation, the correct use of CPT and ICD-10 codes, missed billing opportunities and erroneously reported services to minimize errors and loss of revenue.
• Interacts with and provides trends to management, revenue managers and others about coding related issues.
• Solves any coding related problems and/or answers questions regarding coding issues from the provider, office staff and billing specialists.
• Collaborates with billing specialists and appeal and edit coders to expedient resolution of accounts.
• Works together with billing specialists to develop plans to improve charge capture and billing/coding processes.
• Stays current with CPT and ICD-10-CM coding guidelines and updates.
• Communicate changes and/or updates to key stakeholders including physicians, ACPs, practice managers and leadership.
• Reports any potential compliance issues to the Director of RCM.

Provider Coding Auditor, Educator

• Auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs billed and reimbursed
• Analyzing and auditing claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance of medical audit activities
• Utilizing audit tools, auditing workflow systems and reference information to generate audit determinations and formulate detailed audit findings letters
• Maintaining accuracy and quality standards as established by audit management
• Identifying potential documentation and coding errors by recognizing aberrant coding and documentation patterns
• Suggesting and developing high quality, high value, concept and or process improvement and efficiency recommendations

Clinical Validation Auditor – RN, CDI, MS-DRG, AP-DRG, APR-DRG

• The Premium Insurance Field Auditor conducts insurance policy audits for Worker’s Compensation, Auto and General Liability policies.
• This is done by auditing the policyholder’s records according to client company standards.
• If you are looking for a fast paced, self-motivating work environment from home, this job may be for you!
• Working from your home office, this role requires scheduling appointments with the insured to be audited and obtain necessary documentation for our insurance company client audits all while adhering to customer requirements and quality standards.
• Territory: Baltimore, MD and surrounding areas

Premium Insurance Field Auditor

• The Premium Insurance Field Auditor conducts insurance policy audits for Worker’s Compensation, Auto and General Liability policies.
• This is done by auditing the policyholder’s records according to client company standards.
• Working from your home office, this role requires scheduling appointments with the insured to be audited, and travel on an average of 4 days per week within your assigned territory to meet with the insured and obtain necessary documentation for our insurance company client audits all while adhering to customer requirements and quality standards.

Experienced Premium Insurance Field Auditor

• Performs audit activities as assigned by the Area and/or Regional Manager.
• Audit responsibilities will include determining audit priorities and scheduling to meet stated deadlines, preparation of appointment letters, performing detailed review of all related business records, and preparing written reports of findings.
• Meets with business owners/managers to review audit results and implement any actions required.
• Transmits completed reports to Quality Review for handling by the required due date.
• Corrects and completes audits previously returned for correction and transmits back to Quality Review in a timely manner by Auditor expectations and SOP.
• Maintains accurate audit and business records related to, but not limited to, audit assignments, expense reports, time reporting, etc.
• Performs other duties as assigned.

Auditor jobs in Maryland

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Internal Auditor II

Premium Auditor

Senior Auditor, Cell Therapy Quality

Principal Auditor

Clinical Provider Auditor II – Behavioral Health

Premium Auditor

Clinical Provider Auditor Lead – Behavioral Health

Provider Coding Auditor, Educator

Clinical Validation Auditor – RN, CDI, MS-DRG, AP-DRG, APR-DRG

Premium Insurance Field Auditor

Experienced Premium Insurance Field Auditor

Insurance Field Auditor