Auditor

• Performs audits of medical record documentation to determine the accuracy of principal and secondary diagnosis (including MCC & CC) and procedure codes.
• Adheres to official coding guidelines, coding clinics and regulatory guidelines and mandates.
• Utilizes proprietary auditing systems with a high level of proficiency to document audit determinations and rationale.
• Actively cross-trains to perform reviews of multiple claim types to provide a flexible workforce to meet client needs.
• Maintains current knowledge of coding guidelines and successfully completes required CEUs to maintain coding certification.

Outpatient Coding Auditor

• Travel daily throughout a defined territory *Company Vehicle Provided*
• Conduct entry-level commercial energy audits for small and mid-sized facilities
• Engage directly with customers and contractors to explain program offerings, encourage participation, and address basic questions
• Accurately document inspections, installations, and customer interactions in accordance with program requirements
• Perform on-site installation of energy efficiency measures, including physical labor and use of basic tools
• Identify, troubleshoot, and escalate basic technical or installation issues to program staff as needed

Commercial Energy Auditor

• Ensuring the accuracy and completeness of clinical coding resulting in appropriate reimbursement and data integrity.
• Conducts regular coding audits and coordinates ongoing monitoring of coding accuracy.
• Develops and coordinates educational sessions to all coding staff regarding documentation and accurate coding.
• Serves as a resource for coding staff on organization-wide coding and documentation standards and guidelines.
• Designs audit tools to monitor the accuracy of clinical coding.
• Keeps abreast of coding guidelines and reimbursement reporting requirements.
• Conducts trend analyses to identify patterns and variations in coding practices.

Coding Compliance Auditor

• 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.
• Assists with training of new associates.

Clinical Provider Auditor II – Payment Integrity

• Audit major components of business units
• Assist in developing engagement planning documentation
• Design and execute internal control testing
• Prepare clear and organized documentation
• Establish and maintain good client and team relations
• Communicate audit progress effectively
• Perform various engagement administration tasks

Senior Staff Auditor, Finance

• Supports the Corporate Audit Services (CAS) Compliance team by executing audit engagements to assess business processes, identify key compliance risks and controls, and evaluate control design and effectiveness.
• Performs or oversees control testing and documenting results in accordance with internal audit standards.
• Partners with Lines of Business and RCA stakeholders to strengthen risk management practices and ensure compliance with applicable laws and regulations.
• Identifies control gaps, recommends mitigation strategies, escalates risks as appropriate, and serves as a liaison across the Lines of Defense.
• Assists the audit team management in planning audit engagements.
• Performs or supervises staff auditors in the testing of controls based on audit program directions.
• Drafts audit issues under the supervision of the audit team management.
• Assists the audit team management in the reporting and wrap-up phases of audits.
• Applies insights and guidance gained through coaching.
• Performs other duties as requested by management.

Senior Auditor - Compliance

• Audit Responsibilities: Plan, lead, and/or conduct second party QMS audits for compliance with the 91XX and ISO series of standards, RTX and business unit policies & procedures, and regulatory and customer requirements across RTX sites.
• Perform formal responsibilities of a lead auditor such as audit planning in conjunction with the EQA audit planner, representing the audit team with site leadership, conducting opening and closing meetings, and daily debriefs with site personnel.
• Ensure that processes, products, and services comply with internal standards, regulatory requirements, and industry best practices.
• Complete and issue detailed audit reports, including findings, non-conformances, and review and approve effective corrective actions and ensure implementation effectiveness.
• May assist RTX Certification bodies during site surveillance and recertification audits, including facilitating audit schedules, logistics, and closure of corrective actions.
• Data Analysis: Support analysis of audit performance to identify trends, risks, and opportunities for continuous improvement.
• Utilize data analytics to support comprehensive audit preparation and planning based on historical and current performance data.
• Collaboration: Work closely with regional leads of the EQA team and Ops Excellence lead to support the audit schedule, ensuring that sites across RTX are audited per the schedule.
• Foster collaborative relationships with functional and business leaders to promote a transformative quality organization aligned with business objectives.
• Participate in weekly Corrective Action Review Board meetings to review and approve/reject formal corrective actions.
• Special Audits and Assessments: Support special audits (e.g., suspensions, major customer complaints, high-risk sites, etc.), independent assessments, and site certifications as required by RTX business units.

Principal Specialist, Quality System Compliance Auditor

• Perform regularly scheduled in plant audits as requested by the Regional Inspection Manager.
• Perform on-site scheduled audits as requested by Regional Inspection Manager.
• Perform product sampling as requested by Regional Inspection Manager
• Continually monitor the client’s implementation of approved quality systems.
• Continually evaluate and communicate the status of each client’s quality system to the Regional Inspection Manager.
• All inspection reports will be sent to the Regional Inspection Manager for review by the end of each month.
• Establish excellent relationships with States and HUD to ensure we are respected as a leader and partner
• Ensure all applicable ICC NTA procedures are consistently followed in the execution of inspection jobs.
• Continually identify, recommend, and pursue opportunities for process improvements within the Department and ICC NTA.
• Promote effective communication throughout the organization.
• Identify opportunities and recommend actions that will enhance communication among all employees.
• Contribute on an ongoing basis, insights and ideas for resolving repetitive issues as they arise in the field by establishing and maintaining a consistent line of communication with Inspection Managers.
• Perform other duties, responsibilities, and special assignments as directed by the Regional Inspection Manager.

Quality Auditor – Building Inspections

• Assist the audit team management in planning audit engagements.
• Perform or supervise staff auditors in the testing of controls based on audit program directions.
• Draft audit issues under the supervision of the audit team management.
• Assist the audit team management in the reporting and wrap-up phases of audits.
• Apply feedback and coaching to improve performance and outcomes.
• Perform other duties as requested by management.

Senior Auditor – Banking Products

• Perform risk assessments of business activities and relevant testing
• Assist in communicating issues, risks and recommendations to management
• Operate independently and meet high-quality standards
• Develop working relationships with business partners and Audit group
• Leverage data analytics during audit delivery phases
• Proactively follow-up on audit actions and commit to management deadlines

Senior Staff Auditor, Consumer Lending

• Lead small audits, or own completion of significant components of larger audits related to the payment network.
• Develop engagement planning documentation for assigned areas to communicate rationale for scoping decisions, and develop audit programs to ensure adequate coverage of risks.
• Design and execute appropriate audit procedures to verify the effectiveness of internal controls.
• Document auditee processes and procedures, review and analyze evidence, and identify potential issues.
• Prepare clear, organized, and complete documentation to support work performed, including draft findings.
• Establish and maintain good client and team relations during engagements.
• Effectively communicate information and audit progress to team, clients and auditor-in-charge.
• Self prioritize and effectively plan your own work activities managing multiple priorities and tasks across the team to deliver quality results.
• Proactively take on additional work to support the team when possible.
• Provide coaching, on-the-job training, and feedback to audit staff, including junior associates and recent hires.

Principal Auditor – Global Payment Network

• Responsible for daily operations pertaining to Risk Adjustment including but not limited to: medical record reviews to report ICD-10-CM diagnosis codes for ACA and MA lines of business, potential Centers of Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record retrieval efforts.
• Mitigate risk by validating Encounter Data Gathering Environment Server (EDGE) data is supported within provider encounter documentation
• Review the performance of the Risk Adjustment Coding team and report audit trends to Leadership in a timely, consistent and effective manner to ensure the appropriate changes and education are implemented.
• Maintain compliance with national standards and coding practices set by the ICD-10-CM coding guidelines for accuracy, as well as compliance with Risk adjustment production standards.
• Conduct CMS audits of Risk Adjustment activities, including but not limited to Risk Adjustment Data Validation audits.
• Develop relationships with key individuals to foster an increased understanding of the Risk Adjustment process.
• Identify and execute on the creation of clinical document improvement resources for provider education in both MA and ACA line of business.
• Manage the implementation process improvements that will maximize risk adjustment factor increases.
• Compliance with all applicable laws and regulations
• Other duties as assigned

Auditor, Risk Adjustment

• Determining proper premium for risks by auditing policyholder’s records
• Verifying operations, classifications, and allocations of exposures
• Identifying additional exposures ensuring proper premium calculations
• Communicate findings to insureds, underwriters, brokers, and unit stat filings to NCCI and State Bureaus
• Report changing financial conditions and operations to Underwriting
• Review claims to verify employment and proper classifications

Senior Field Auditor Specialist

• Perform independent assessments of governance, risk management, and control processes across the organization.
• Lead smaller scope audits, evaluate compliance with regulations, legislation, and enterprise contracts.
• Identify opportunities to recover unreported value.
• Collaborate with cross-functional stakeholders, leverage data mining and analytical tools to conduct research and testing, and provide recommendations that strengthen business processes and controls.
• Thrive in a team-oriented environment while independently managing multiple priorities with minimal oversight.
• Develop audit programs and testing procedures to assure compliance with lower-risk Vizient contracts, internal controls, and organizational policies.
• Verify contractual compliance by designing and performing analyses using disparate data sources and multifaceted contract terms.
• Communicate non-compliance issues and recommendations through clear, concise, and organized communications tailored to the audience’s needs.
• Adhere to the Quality Assurance and Improvement Program (QAIP) throughout all phases of audit projects.

Auditor, Compliance

• Works with Operations, Fleet, and other core business functions to identify operational and financial inefficiencies to support core initiatives
• Maintains a solid familiarity with WM Way and other changes to operational procedures (collection and post-collection)
• Conducts on-site operational audits at locations across North America and Canada, including direct observation of frontline processes, yard and facility walkthroughs, and interviews with site leadership and frontline employees
• Assesses consistency of SOP execution across locations, identifying behavioral, cultural, or environmental drivers impacting adherence
• Viewed as a technical or subject matter expert with demonstrated understanding of the following: WM corporate and field operations, financial, operational, or digital components
• Interacts with mid and upper management of areas being audited to ensure professional and quality-driven execution of the audit work. Supports mindset and coaching development
• Assists to continue to advocate the department’s vision in relation to employee development and is proactive in that charge
• Works closely and collaborates with multiple managers and areas of IAC to develop and use effective tools and capabilities
• Effectively supervises small teams for projects and ensures that conclusions in line with WM’s policies and procedures
• Assists in maintaining the audit schedule for effective use of resources and meeting departmental commitments, coordinating with other management team members as appropriate
• Ensures the teams conducts root cause analysis, adding business value beyond compliance auditing
• When requested, assist management in developing and implementing a plan to correct deficiencies or leverage opportunities
• Provides risk consultation/advisory services to all parts of the company, which may include travel up to 50% of the time
• Conducts follow-up reviews to assure expected outcomes are realized
• Prepares well written, accurate and timely reports for presentation to appropriate management

Operations Auditor

• Conduct Internal Audits: Support lead consultants by conducting internal audits for first-time implementations and ongoing support services.
• Assess & Document Compliance: Review customer documentation, assess quality management systems, and conduct audits to help clients prepare for external certification audits.
• Audit Scheduling: Manage audit scheduling and ensure assigned audits are completed accurately and on time.
• Support Continuous Improvement: Identify opportunities to improve internal audit processes and contribute to enhancing customer satisfaction and service quality.

Quality 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

• The auditor will receive additional training and is then expected to support the American Petroleum Institute (API).
• The Auditor is an experienced professional capable of performing Quality Management Systems (QMS) audits of manufacturing, oil & natural gas service organizations.
• Auditors have extensive knowledge and the skillset to perform technical audits against product specifications, performance criteria, management systems, and contract requirements.
• This position will be based at locations within the operational areas when on assignment.

API Auditor

• Support the audit methodology update and related enhancement efforts, including conducting research and analysis
• Design and execute best-in-class operational processes
• Coordinate and execute on small to moderately complex projects
• Design and deliver verbal and written communications to audit teams and audit leadership
• Leverage available data and analytical tools to drive deeper insights
• Establish and maintain good relations with audit teams and other key stakeholders
• Provide training to audit team members
• Provide guidance and coaching to audit teams on the application of methodology

Senior Auditor, Audit Professional Practices – Methodology

• Plan, perform, and lead large/complex audits at the enterprise level as well as other diverse lines of business and specialty areas
• Help to implement the team's strategic imperatives/priorities
• Establish and build working relationships with internal and external management
• Provide significant input into the development of the annual audit plan
• Design and perform compliance audit procedures, including identifying and defining issues, reviewing and analyzing evidence, and documenting processes
• Leverage available data and analytical tools during the planning, fieldwork, and reporting phases of audit delivery
• Communicate the results of audit projects to management (written reports/oral presentations)
• Manage staff during audit engagements and provide feedback on work performed

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