Auditor

• Develops and implements strategic needs analyses and training plans for coding leadership
• Coordinates and evaluates curriculum development
• Conducts the preparation and delivery of training for Medical Coders
• Provides guidance and leadership to coding and billing management
• Performs annual performance reviews and quality assurance reviews
• Serves as a subject matter expert for professional fee coding
• Ensures information meeting professional coding standards is accurate and current
• Monitors and audits inpatient and outpatient accounts
• Assesses educational needs of coding staff
• Develops programs or researches educational resources
• Assists with training new and existing staff
• Coordinates the presentation of ongoing professional seminars and materials
• Performs miscellaneous job-related duties as assigned
• Provides reports of audit findings to coding management and leadership

Physician Coding Auditor

• Identifying issues and/or entities that may pose potential risk associated with fraud and abuse
• 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 and continue to next step in the claims lifecycle
• Researches new healthcare related questions as necessary to aid in investigations and stays abreast of current medical coding and billing issues, trends and changes in laws/regulations
• 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

Clinical Provider Auditor I

• Prepare audit pre-work via prescribed method and more broadly as required.
• Prepare pre-work communications, documents.
• Monitor items requiring post-audit follow-up.
• On-going maintenance of pre-work schedules.
• Assemble pre-work data in pre-determined format for RFA review and inclusion in final audit packet.
• Assist with RFA requests for supporting documentation as required.
• Assist with preparation & planning of investigative efforts.
• Liaison with other departments to streamline pre-work assembly, research and post-audit follow-up efforts.
• Prepare analysis and queries as directed.
• Identify, maintain a schedule of HC undergoing office replacement or remodel.
• Identify, maintain schedules of pertaining to special aspects of audits.
• Follow-up on findings when necessary.
• Log special circumstances for use in pre-work stage of audit.
• Log, track other HC metrics and timelines as identified.
• Assist with integration of various audit results/findings into the current audit plan.
• Serve as a central point of coordination for pre-fieldwork logistics, readiness tracking, and information flow between field auditors and operational stakeholders.
• Ensure field audit teams arrive onsite with complete background materials, validated data sets, and clearly defined operational focus areas.
• Provide ongoing off-site support during fieldwork by responding to follow-up data or documentation requests.
• Assist in research of new data analytics and tools including helping to validate those evolving tools.
• Research red flags to provide the Auditors with information to facilitate their ongoing and upcoming auditors.

Field Auditor Coordinator III

• Support various functions across the Clayton enterprise
• Collaborate with team members to achieve organizational goals

Associate Auditor

• Leads and performs complex internal audits and coordinates related large-scale projects.
• Identifies, documents, and analyzes audit findings and develops audit programs that address and test identified key risks.
• Performs follow-up audits and monitoring to ensure appropriate adherence to policies and procedures.
• Monitors compliance with regulations and controls by examining and analyzing records, reports, operating practices, and documentation.
• Evaluates opportunities for improvement, develops recommendations, and presents improvement opportunities/audit findings to leadership.
• Acts as a resource to educate, consult and collaborate with staff on various audit related topics.
• Guides and educates departments on methods to decrease risk and increase compliance in organizational-wide programs, policies, and procedures.
• Assists the independent external auditors by gathering information, answering questions, executing testing, coordinating any further assistance needed, and performing related projects.
• Assists with establishment of annual audit plans by leading discussions with management to identify timing, scope and objectives of audits.
• Assists with the coordination of risk models/assessments to identify and develop an audit plan to address potential risks for specific audit scope areas.
• Ensures alignment of audit and project plans with risk assessment.

Senior Internal Auditor – Compliance

• Responsible for maintaining the Document Control Center, Data and Records of the Quality System.
• Support, documentation and follow up on Internal Audits, QMS/QIS, and Corrective Actions raised from Internal Audits.
• Update visual aids, process instructions, quality procedures, corrective and preventive actions, client documentations.
• Generate and update control charts as well as Quality QOS.
• Review and validation of all controlled documentation used and displayed throughout the plant against QIS.
• Participate in the Continuous Improvement Projects.
• Perform plant tours to detect any activity not in compliance within the quality.
• Keep under clean and organized conditions, the workstation and/or area.
• Manage/follow up of aged material process; notify Customer for proper disposition.
• Maintain Vendor/Parts profile updates in the system.
• Prepare all paperwork and backup data for return shipments.
• Ensure customer responses are made within customer service objectives.
• Responsible for several reports and monitor compliance.
• Setup and maintain all vendor, contact, and part profile information.

Quality Auditor

• Conducting financial/operational audits.
• Internal control assessments.
• Strategy reviews.
• Special projects and risk assessment activities.
• Lead the development and execution of high quality assessments of the Company’s complex processes and controls.
• Identify risks and collaborate with team leadership, business management and external auditors on audit planning, testing and evaluation procedures.
• Prepare clear, accurate and concise audit work papers.
• Present findings/deficiencies to the lead auditor with recommendations for remediation.
• Review work performed by others and provide recommendations for improvement.
• May support internal and external audit/compliance groups with various activities.

Senior Internal Auditor

• Build and maintain strong relationships with key business stakeholders to support audit engagement success and promote collaboration
• Independently assesses functions and activities to evaluate operational effectiveness and control adequacy
• Plan and scope audits that align with organizational priorities and risk profiles
• Analyze complex data and evidence to form objective, actionable insights
• Communicate findings clearly and persuasively to senior leadership
• Prepare high-impact audit reports tailored to stakeholder needs
• Monitor finding remediation efforts and provide strategic guidance on risk mitigation
• Serve as a subject matter expert and escalation point for complex issues
• Mentor junior team members, fostering a culture of excellence and continuous improvement
• Contribute to cross-functional initiatives and strategic projects

Senior Internal Auditor – Information Technology, IT

• Plan, lead, and execute EHS and environmental compliance audits at client facilities across the U.S.
• Perform hands-on environmental compliance assessments, evaluating conformity with applicable federal, state, and local environmental regulations (air, waste, water, chemical management, etc.)
• Conduct on-site inspections, employee interviews, and document reviews to identify compliance gaps and regulatory risks
• Prepare clear, accurate, and high-quality audit reports, including findings and corrective action recommendations
• Provide technical review and quality assurance of audit deliverables prepared by other team members
• Collaborate directly with industrial clients to deliver EHS compliance management services and practical, implementable solutions
• Consistently meet or exceed client expectations related to scope, schedule, budget, and technical quality
• Support long-term client relationships that drive repeat business and ongoing engagements
• Travel to client sites approximately 25–50% of the time

EHS Auditor – Consultant

• Perform internal audits, including the execution of information technology, strategic, operational, financial, and compliance risk-based audits
• Execute risk-based audits evaluating controls and processes for scalability, effectiveness, efficiency, and risk mitigation strategies
• Assist in audit planning, refinement of audit work programs, and wrap up of engagements
• Assist in drafting audit reports that summarize audit findings and recommendations
• Develop and communicate audit observations, recommendations, process improvement opportunities, and best practices and obtain management responses
• Monitor and report on the status and findings of audits
• Assist audit team in performing special projects and implementing internal audit best practices
• Performs other duties as assigned

IT Internal Auditor II

• Perform detailed claims payment quality reviews and coding compliance audits
• Communicate audit results and recommend corrective actions
• Review claims materials and medical record information
• Plan and conduct investigations for certain claims

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