Auditor

• Assisting the audit team management in planning audit engagements
• Performing or supervising staff auditors in the testing of controls based on audit program directions
• Interviewing auditees; identifying and analyzing business processes; and documenting work performed in TeamMate Audit Solutions to support audit scope/conclusions and meet CAS Policies, Standards and Guidelines
• Drafting audit issues under the supervision of the audit team management
• Assisting the audit team management in the reporting and wrap-up phases of audits
• Learning from and applying coaching received
• Building and maintaining relationships with stakeholders, establishing a culture of engagement while adding value
• Maintaining a good understanding of key processes within the Centralized Operations area
• Performing other duties as requested by management

Senior Auditor – Payment Operations, Money Movement

• Manage the audit lifecycle for assigned audits, including planning, executing fieldwork, scheduling interviews, and conducting audit tests.
• Conduct walkthroughs, develop scope documents, and map control matrices to frameworks such as COSO and NIST.
• Apply internal audit methodology and standards throughout the audit process, including risk assessment and control evaluation.
• Document audit findings, prepare workpapers and audit reports, and present results to management.
• Provide recommendations to improve processes and mitigate risks and lead remediation follow-up activities.
• Prepare for and lead internal and external status meetings; direct and review the work of Staff Auditors to identify risks and dependencies and ensure timely, quality deliverables.
• Contribute to the continuous professional development of audit staff and to improvements in audit methodology and tools.

Senior IT Auditor

• Completing audit engagement assignments with minimal supervision from the audit team management
• Understanding risk and risk management techniques, identify and analyze business processes, key risks and critical controls
• Evaluating control design adequacy
• Performing or supervising control testing
• Documenting work performed in conformance with internal audit policies and procedures
• Assisting the audit team management in planning audit engagements
• Interviewing auditees
• Drafting audit issues under the supervision of the audit team management
• Assisting with drafting audit reports
• Performing other duties as requested by management

Senior Auditor – Payment Services

• 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

• 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

• Collaborates with clinical documentation team in the review of inpatient accounts (with an emphasis on mortality reviews) identifying documentation improvement opportunities
• Assess DRG, PDx, secondary Dx, PCS, POA and all other components of documentation that impact quality metrics
• Consistently assures coding practices remain compliant with coding guidelines and regulations
• Continually identifies educational opportunities related to coding and documentation
• Expert educator to clinical teams and medical staff
• Identifies strategic plans that will result in a positive impact to the clinical dashboard
• Develops clinical relationships across the health system securing interdepartmental support necessary for successful implementation of education strategies assuring achievement of overall strategic targets
• Ability to multi-task a variety of audits
• Ability to analyze data and construct appropriate action plans
• Develops teaching tools to promote quality outcomes
• Is an active member of clinical and executive meetings as identified
• Advanced understanding of quality metrics for health system (Vizient, PSI, USNWR)
• Advanced understanding of clinical documentation and coding through the lens of local and national quality and ranking methodologies, including but not limited to, U.S News and World Report, Vizient, Leapfrog, the CMS Star Rating, and payer contracts and assists the Managers of Clinical Documentation and Coding in implementing key strategies to effect change.
• Partners with Coding, Clinical Documentation leadership and Medical Directors to coordinate, maintain, and execute advanced project work that includes but, is not limited to, Mortality Review, HAC/PSI Review, Quality Abstraction and Analysis, and/or special and non-traditional project work.
• Partners with NM departments that includes but is not limited to: IT; Analytics; and Innovation to design and implement new and advanced workflow solutions.
• Partners with third-party consultants/partners to contribute to workflow and methodology build and refine as necessary.

Coding Quality Auditor, Specialist

• Responsible for delivering BSI’s audit services to assigned clients
• Manage a portfolio of assigned clients based on location
• Conduct various types of audits as Team Leader or Team Member
• Monitor the client accounts to ensure client satisfaction is maintained
• Follow the training plan developed by the Scheme Director
• Lead teams when necessary, mentor, and coach new or inexperienced colleagues

Automotive Management Systems Auditor

• Analyze all customer feedback for trends and continuous improvement
• Investigate quality issues to identify root causes and ensure issues are addressed and resolved
• Assist in defining and improving processes as part of a team
• Review, compile, and analyze information to prepare reports
• Utilize data monitoring tools to highlight analysis priorities
• Identify gaps in efficient process workflow and suggest steps for supplier quality process improvement
• Collect, prepare and analyze data for corrective action and process improvement
• Support production operations and critical business situations
• Provide clear direction for change and assists in change management
• Document the results of all inspections
• Understand product quality requirements and serve as a resource for quality assurance and approval as needed
• Actively engage in cross-training to acquire skills and knowledge from various roles within the department
• Collaborate with team members to learn and apply multiple functions across different job positions to support departmental objectives

Auditor jobs in Wisconsin

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Senior Auditor – Payment Operations, Money Movement

Senior IT Auditor

Senior Auditor – Payment Services

Clinical Provider Auditor II – Payment Integrity

Clinical Provider Auditor II – Payment Integrity

Senior Auditor – Banking Products

Senior IT Auditor

Coding Quality Auditor, Specialist

Automotive Management Systems Auditor

Quality Auditor