Auditor jobs at Harris & Associates - 219 jobs

We do Consulting Differently The Healthcare Compliance Auditor position is a staff consulting position within the Healthcare Transactions and Strategy (HTS) group. HTS is currently seeking a Healthcare Compliance Auditor at either the Consultant or Managing Consultant level. HTS performs regulatory, reimbursement, data analytics, and compliance auditing for healthcare providers, healthcare payers and healthcare investors. Compliance audit deliverables include assessment of provider compliance programs and auditing of billing and coding of clinical documents and claims documents. This position requires a highly motivated problem solver with strong analytical ability, solid organizational skills, and a desire to advance within the organization. The work of a Healthcare Compliance Auditor will involve execution of engagement work streams that will primarily involve employing certified coding skills to audit provider claims and provider clinical documentation with a particular focus on government programs such as Medicare and Medicaid. Responsibilities include working with team to develop audit specifications, expert analysis of healthcare claims and supporting documentation, quality control, and development of client deliverables. The work of a Consultant involves execution of engagement work streams that may be either qualitative or quantitative in nature, and responsibilities include: billing and coding audits, compliance program review, quality control, development of client deliverables, and industry research. The work of a Managing Consultant involves both execution and oversight of engagement work streams that may be either qualitative or quantitative in nature, and responsibilities include: management of junior staff, quality control, development and presentation of client deliverables, and industry research. This specific position will require knowledge of medical coding and compliance and potential candidates must have medical auditing expertise. Job title and compensation to be determined based on qualifications and experience. Job Responsibilities: Plan and perform medical record audits to determine coding accuracy and compliant claims submission; Develop coding and documentation audit methodology using knowledge of key risk areas in coding and documentation compliance; Perform coding and documentation audits, reviewing medical records and charges to ensure compliance with CPT-4/HCPCS and ICD-10-CM coding guidelines and standards, as well as the Centers for Medicare & Medicaid Services (CMS) coverage guidelines; Conduct analysis of audit findings to identify trends/problems in coding and documentation and effectively communicates the audit findings and recommended areas for improvement; Serve as a subject matter expert on interpretation and application of coding and documentation guidelines; Monitor relevant resources, publications, and current government compliance and enforcement activity related to high-risk compliance areas; Stay current on coding guidelines. Develop analyses using transactional data and/or financial data; Generate client deliverables and make valuable contributions to expert reports; Manage client relationships and communicate results and work product as appropriate; Manage junior staff and delegate assignments as directed by more senior managers; Demonstrate creativity and efficient use of relevant software tools and analytical methods to develop solutions; Participate in group practice meetings, contribute to business development initiatives and office functions such as staff training and recruiting; Prioritize assignments and responsibilities to meet goals and deadlines. Qualifications: An undergraduate degree (e.g., BS, BA); Active coding certification from either AAPC or AHIMA is required; Preference will be given to candidates that are certified in medical auditing; 2+ years of work experience with a focus on healthcare provider billing and coding; 5-7 years of experience is required for the Managing Consultant level position. Job title to be determined based on relevant qualifications and experience. Preference will be given to candidates that are experienced with physician practice coding (e.g. primary care, dermatology, orthopedics, ophthalmology), ASC coding, and/or post-acute coding (e.g. hospice, home health, SNFs). Comprehensive knowledge of Medicare rules, regulations, and guidelines as they apply to coverage, coding, and provider documentation. Advanced knowledge of CPT-4, HCPCS, and ICD-10-CM coding systems, guidelines, and regulatory requirements. Required skills include: Demonstrated ability to interpret national coding and documentation guidelines and translate them into effective auditing practices and tools; identify issues in coding and documentation practices and recommend corrective action; develop reports, track, and trend audit findings and results. Proficient user in Microsoft Office Suite, specifically Excel, PowerPoint, Access, and Word. A desire to expand those capabilities is required, as is the ability to train others to use such tools. Commitment to producing high quality analysis and attention to detail. Excellent time management, organizational skills, and ability to prioritize work and meet deadlines. Keen interest in healthcare compliance and healthcare policy. Exceptional verbal and written communication skills. Desire to work within a team environment. Candidate must be able to submit verification of their legal right to work in the U.S., without company sponsorship. Consultant Salary Range: $70,000 - $150,000 Managing Consultant Salary Range: $100,000 - $230,000 #ThinkBRG #LI-JQ1|#LI-REMOTE About BRG BRG combines world-leading academic credentials with world-tested business expertise purpose-built for agility and connectivity, which sets us apart-and gets you ahead. At BRG, our top-tier professionals include specialist consultants, industry experts, renowned academics, and leading-edge data scientists. Together, they bring a diversity of proven real-world experience to economics, disputes, and investigations; corporate finance; and performance improvement services that address the most complex challenges for organizations across the globe. Our unique structure nurtures the interdisciplinary relationships that give us the edge, laying the groundwork for more informed insights and more original, incisive thinking from diverse perspectives that, when paired with our global reach and resources, make us uniquely capable to address our clients' challenges. We get results because we know how to apply our thinking to your world. At BRG, we don't just show you what's possible. We're built to help you make it happen. BRG is proud to be an Equal Opportunity Employer. Our hiring practices provide equal opportunity for employment without regard to race, religion, color, sex, gender, national origin, age, United States military veteran status, ancestry, sexual orientation, marital status, family structure, medical condition including genetic characteristics or information, veteran status, or mental or physical disability so long as the essential functions of the job can be performed with or without reasonable accommodation, or any other protected category under federal, state, or local law.

What if you could build a career where ambition meets innovation? At LPL Financial, we empower professionals to shape their success while helping clients pursue their financial goals with confidence. What if you could have access to cutting-edge resources, a collaborative environment, and the freedom to make an impact? If you're ready to take the next step, discover what's possible with LPL Financial. Job Overview: We are currently looking to hire a Staff Internal Auditor within the Internal Audit department. This individual will be responsible for executing finance, operations, and compliance related internal audits, SOX and Operational control testing, process reviews and various ad hoc projects assigned to them. Responsibilities: Performs tests of design and operating effectiveness of key internal controls which includes the performance of walk-throughs and documenting processes, control testing, evaluation of control deficiencies and coordination with external auditors Performs audits of financial, operational and other business risk areas for adequate management controls, efficiency, and compliance with policies, regulations and accounting principles Makes recommendations for changes to streamline and improve internal control processes and department procedures Documents business systems/processes using narrative and/or flowcharting techniques and prepares work papers that contain adequate evidence to support audit conclusions and findings Performs follow up procedures on previously identified outstanding audit issues and assists in the status update reporting process Keeps up-to-date with the industry's best practices by initiating and attended job related training What are we looking for? We're looking for strong collaborators who deliver exceptional client experiences and thrive in fast-paced, team-oriented environments. Our ideal candidates pursue greatness, act with integrity, and are driven to help our clients succeed. We value those who embrace creativity, continuous improvement, and contribute to a culture where we win together and create and share joy in our work. Requirements: Undergraduate degree in Business, Accounting, Finance or related discipline. Minimum Experience Required: 2+ years of internal or external auditing experience, including SOX controls testing. Core Competencies: General understanding of internal control and the demonstrated ability to evaluate and determine the adequacy of controls by considering regulatory and business risks. Interact internally with staff, management, and occasionally senior management. Ability to multi-task, think independently and problem solve in a results driven team oriented environment Excellent written and verbal skills and demonstrated ability to present complex issues to management A helpful, respectful and personable approach to client and coworker interactions The ability to listen, empathize and respond in a timely manner Personal pride in delivering exceptional experiences to clients and coworkers Preferences: Preferred: Pursuing or attained one applicable audit designation (CPA, CIA, CFE, CISA, etc.). Preference will be given for experience in financial services (e.g., Broker/Dealer or RIA) #LI-PA Pay Range: $30.64-$51.07/hour Actual base salary varies based on factors, including but not limited to, relevant skill, prior experience, education, base salary of internal peers, demonstrated performance, and geographic location. Additionally, LPL Total Rewards package is highly competitive, designed to support your success at work, at home, and at play - such as 401K matching, health benefits, employee stock options, paid time off, volunteer time off, and more. Your recruiter will be happy to discuss all that LPL has to offer! Company Overview: LPL Financial Holdings Inc. (Nasdaq: LPLA) is among the fastest growing wealth management firms in the U.S. As a leader in the financial advisor-mediated marketplace(6) , LPL supports over 32,000 financial advisors and the wealth management practices of approximately 1,100 financial institutions, servicing and custodying approximately $2.3 trillion in brokerage and advisory assets on behalf of approximately 8 million Americans. The firm provides a wide range of advisor affiliation models, investment solutions, fintech tools and practice management services, ensuring that advisors and institutions have the flexibility to choose the business model, services, and technology resources they need to run thriving businesses. For further information about LPL, please visit ************ At LPL, independence means that advisors and institution leaders have the freedom they deserve to choose the business model, services, and technology resources that allow them to run a thriving business. They have the flexibility to do business their way. And they have the freedom to manage their client relationships, because they know their clients best. Simply put, we take care of our advisors and institutions, so they can take care of their clients. For further information about LPL, please visit ************ Join LPL Financial: Where Your Potential Meets Opportunity At LPL Financial, we believe that everyone deserves objective financial guidance. As the nation's leading independent broker-dealer, we offer an integrated platform of cutting-edge technology, brokerage, and investment advisor services. Why LPL? Innovative Environment: We foster creativity and growth, providing a supportive and responsive leadership team. Learn more about our leadership team here! Limitless Career Potential: Your career at LPL has no limits, only amazing potential. Learn more about our careers here! Unified Mission: We are one team on one mission-taking care of our advisors so they can take care of their clients. Learn more about our mission and values here! Impactful Work: Our size is just right for you to make a real impact. Learn more here! Commitment to Equality: We support workplace equality and embrace diverse perspectives and backgrounds. Learn more here! Community Focus: We care for our communities and encourage our employees to do the same. Learn more here! Benefits and Total Rewards: Our Total Rewards package goes beyond just compensation and insurance. It includes a mix of traditional and unique benefits, perks, and resources designed to enhance your life both at work and at home. Learn more here! Join the LPL team and help us make a difference by turning life's aspirations into financial realities. Please log in or create an account to apply to this position. Principals only. EOE. Information on Interviews: LPL will only communicate with a job applicant directly from ******************** email address and will never conduct an interview online or in a chatroom forum. During an interview, LPL will not request any form of payment from the applicant, or information regarding an applicant's bank or credit card. Should you have any questions regarding the application process, please contact LPL's Human Resources Solutions Center at **************. EAC12.9.25

Treliant is an essential consulting firm serving banks, mortgage originators and servicers, fintechs, and other companies providing financial services globally. We are led by practitioners from the industry and the regulatory community who bring deep domain knowledge to help our clients drive business change and address the most pressing compliance, regulatory, and operational challenges. We provide data-driven, technology-enabled consulting, implementation, staffing, and managed services solutions to the regulatory compliance, risk, credit, financial crimes, and capital markets functions of our clients. Founded in 2005, Treliant is headquartered in Washington, DC, with offices across the United States, Europe, and Asia. Treliant is committed to fostering a diverse, equitable and inclusive environment that values and embraces all races, religions, ages, abilities, genders, sexual orientations, ethnicities, languages, nationalities, political parties, socioeconomic groups and other characteristics that inform an individual's worldview, experiences and system of beliefs (“the principles”). We believe in championing every voice and ensuring everyone's full potential. Treliant is looking for experienced audit professionals with banking or related financial services backgrounds for extended engagements with banking clients. Responsibilities While the scope of each project may be different, your duties & responsibilities may include: Planning and scoping audit test approach. Documenting test procedures, collecting evidence, and documenting test results. Supporting audit execution/issue validation across multiple banking-focused projects and supervising related activities. Overseeing and/or delivering assurance activity related to topics including, but not limited to, audit work per the audit plan, regulatory remediation, and issue validation. Handling other responsibilities, as appropriate. Qualifications 3+ years of direct experience conducting and/or leading audits in various departments of large banking institutions, including, but not limited to, bank operations, consumer/commercial lending, capital and financial risk management, regulatory reporting, finance and accounting, AML/BSA, fraud, and wealth management. Advanced knowledge of relevant banking regulatory rules and frameworks. Benefits Primary Location: Remote Primary Location Salary Range: $60/hr - $150/hr Treliant offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefit package that reflects our commitment to creating a diverse and supportive workplace. In addition to a competitive base salary, candidate is eligible for incentive pay as well as a full range of health benefits, vacation plan, and 401k plan. If you want to be part of a dynamic team of professionals, we invite you to join the team at Treliant. We invest in people, and challenge you to advance your career while achieving your aspirations and goals. Here at Treliant, we pride ourselves on our collaborative team culture, where we embrace diversity of thought and innovation. If you strive for excellence and seek an inclusive environment apply on line treliant.com and follow us on LinkedIn. Right to Work Treliant is not in the position to provide sponsorship for this current position and so applicants must be able to work in the United States without requiring sponsorship. Please note, Treliant receives a high volume of applications for all roles. While we will endeavor to respond to all applicants, this is not always possible. Should you not receive a response to your application within 2 weeks, it is likely that you will have been unsuccessful on this occasion. However, we would like to retain your details on our systems and may contact you should another potentially suitable vacancy arise. Treliant LLC is an Equal Opportunity Employer and does not discriminate on the basis of race, color, national origin, sex, sexual orientation, genetic information, religion, age, disability, or military status in employment or provision of services. When contacted for an interview, an applicant who requires special accommodations due to a disability should notify the office so that proper arrangements can be made.

Job Description Our shared values, including uncompromising integrity, a passion for excellence and mutual respect have helped us get here. If these values align with yours, we'd like to hear from you. Help us continue in our success as an Experienced Audit Staff in our Charlotte, NC, office. As an Audit Staff, you will: Perform audit procedures, over cash, A/R, inventories property and equipment, prepaids, A/P, accrued expenses, debt and general income statement accounts in client financial statements and propose adjusting journal entries when needed. Communicate with client personnel in order to identify and assess existing client accounting processes, internal controls, and compliance with regulatory requirements. Review accounting transactions and consider appropriate application of generally accepted accounting principles. Prepare financial statement footnotes (on areas audited) and internal control observations and recommendations. Research fundamental issues using online tools. Perform other duties as needed on engagements and as assigned by supervisory personnel. What you bring to the role: An ideal fit for our firm displays a passion for superior client service, uncompromising integrity and project management abilities. We're a fast-paced and dynamic environment so a strong sense of urgency will fit right in! 1+ years' experience in public accounting or other industry related experience Experience using Engagement is a plus Bachelor's degree in accounting. Masters preferred CPA certified or the eligibility to work toward obtaining a CPA license Ability to manage multiple responsibilities simultaneously (multi-task) What you can expect from us: Shared values, including uncompromising integrity, a passion for excellence, and mutual respect The opportunity to innovate and do work that motivates and engages you Flexibility to do impactful work and to enjoy your life outside of work, including a firmwide week off for the 4th of July A collaborative environment focused on your career growth and continuous professional development Competitive compensation and a total rewards package that focuses on all aspects of your wellbeing Cherry Bekaert cares about our people. We offer competitive compensation packages based on performance that recognize the value our people bring to our clients and our Firm. The salary range for this position is included below. Individual salaries within this range are determined by a variety of factors including but not limited to the role, function and associated responsibilities, a candidate's work experience, education, knowledge, skills, and geographic location. In addition, we offer a comprehensive, high-quality benefits program which includes annual bonus, medical, dental, and vision care; disability and life insurance; generous Paid Time Off; retirement plans; Paid Care Leave; and other programs that are dedicated to enhancing your personal and work life and providing you and your family with a measure of financial protection. About Cherry Bekaert Cherry Bekaert, ranked among the largest assurance, tax and advisory firms in the U.S., serves clients across industries in all 50 U.S. states and internationally. “Cherry Bekaert” is the brand name under which Cherry Bekaert LLP and Cherry Bekaert Advisory LLC, independently owned entities, provide professional services in an alternative practice structure in accordance with applicable professional standards. Cherry Bekaert LLP is a licensed CPA firm that provides attest services, and Cherry Bekaert Advisory LLC and its subsidiary entities provide business advisory and non-attest services spanning the areas of transaction advisory, risk and accounting advisory, digital solutions, cybersecurity, tax, benefits consulting, and wealth management. For more details, visit cbh.com/disclosure. Cherry Bekaert cares about our people. We offer competitive compensation packages based on performance that recognize the value our people bring to our clients and our Firm. The salary range for this position is $57,000 to $96,500. In addition, we offer a comprehensive, high-quality benefits program which includes annual bonus, medical, dental, and vision care; disability and life insurance; generous Paid Time Off; retirement plans; Paid Care Leave; and other programs that are dedicated to enhancing your personal and work life and providing you and your family with a measure of financial protection. Cherry Bekaert provides equal employment opportunities to applicants and employees without regard to race, color, religion, age, sex, sexual orientation, gender identity/expression, national origin, protected veteran status, disability status, or any other legally protected basis, in accordance with applicable law. Candidates must demonstrate eligibility to work in the United States. Cherry Bekaert will not provide work sponsorship for this position. Cherry Bekaert LLP and Cherry Bekaert Advisory LLC are members of Allinial Global, an accountancy and business advisory global association. Visit us at cbh.com/careers and follow us on LinkedIn, Glassdoor, Instagram, Twitter and Facebook. © 2025 Cherry Bekaert. All Rights Reserved. No Agencies Please #LI-SF1 #LI-Hybrid

Job Description Ranked among the largest accounting and consulting firms in the country, Cherry Bekaert delivers innovative and sophisticated advisory, assurance and tax services to our clients. At Cherry Bekaert we create shared success through teamwork, energy, and expertise. We approach today's toughest business challenges with a client-first mindset, working together to create exceptional value. We are all committed to making a difference for our people, our clients, our community, and our professions. To meet this commitment, Cherry Bekaert will provide you with the space to pursue growth and development opportunities that will guide and support you at each stage of your personal and professional journey. If you are ready to find your space and create your future, you belong with us. As an Audit Staff, you will: As an Audit Staff at Cherry Bekaert, you will work on a wide variety of audit engagements under the supervision of different accounting professionals. Engage and serve clients from various industries Communicate with project in-charges and clients Develop technical accounting skills while performing audits of financial statements Prepare audit checklists and adjust journal entries Gain business writing experience while preparing financial statements alongside clients Prepare and organize workpapers for client files Perform other essential duties as needed What you bring to the role: Bachelor's degree in accounting or related field. Masters preferred CPA certified or the eligibility to work toward obtaining a CPA license Cumulative GPA of 3.0/4.0 or above preferred, but not required Proficiency with computers and spreadsheet software programs Ability to travel to client sites as needed, including frequent same-day travel and occasional out-of-town travel Ability to work moderate overtime throughout the year with heavier overtime required during certain business cycles What you can expect from us: Shared values, including uncompromising integrity, a passion for excellence, and mutual respect The opportunity to innovate and do work that motivates and engages you A collaborative environment focused on your career growth and continuous professional development Competitive compensation and a total rewards package that focuses on all aspects of your wellbeing Flexibility to do impactful work and the time to enjoy your life outside of work About Cherry Bekaert: Cherry Bekaert, ranked among the largest assurance, tax and advisory firms in the U.S., serves clients across industries in all 50 U.S. states and internationally. “Cherry Bekaert” is the brand name under which Cherry Bekaert LLP and Cherry Bekaert Advisory LLC, independently owned entities, provide professional services in an alternative practice structure in accordance with applicable professional standards. Cherry Bekaert LLP is a licensed CPA firm that provides attest services, and Cherry Bekaert Advisory LLC and its subsidiary entities provide business advisory and non-attest services spanning the areas of transaction advisory, risk and accounting advisory, digital solutions, cybersecurity, tax, benefits consulting, and wealth management. For more details, visit cbh.com/disclosure. Cherry Bekaert cares about our people. We offer competitive compensation packages based on performance that recognize the value our people bring to our clients and our Firm. The salary range for this position is$66,000 - $76,000. Individual salaries within this range are determined by a variety of factors including but not limited to education, experience, knowledge, skills, and geographic location. In addition, we offer a comprehensive, high-quality benefits program which includes annual bonus, medical, dental, and vision care; disability and life insurance; generous Paid Time Off; retirement plans; Paid Care Leave; and other programs that are dedicated to enhancing your personal and work life and providing you and your family with a measure of financial protection. Cherry Bekaert provides equal employment opportunities to applicants and employees without regard to race, color, religion, age, sex, sexual orientation, gender identity/expression, national origin, protected veteran status, disability status, or any other legally protected basis, in accordance with applicable law. Candidates must demonstrate eligibility to work in the United States. Cherry Bekaert will not provide work sponsorship for this position. Cherry Bekaert LLP and Cherry Bekaert Advisory LLC are members of Allinial Global, an accountancy and business advisory global association. Visit us at cbh.com/careers and follow us on LinkedIn, Glassdoor, Instagram, Twitter and Facebook. © 2025 Cherry Bekaert. All Rights Reserved.

Audit & Reimbursement III- Medicare Cost Report Audit Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. National Government Services is a proud member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The Audit and Reimbursement III will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health and Human Services). Under guided supervision, the Audit and Reimbursement III will gain experience on complex issues involving the Medicare cost report and Medicare Part A reimbursement. They will participate in contractual Audit and Reimbursement workload, and have opportunities to participate on special projects. This position provides a valuable opportunity to gain further experience in auditing and financial analysis within a growing healthcare industry. This position allows for educational opportunities leading to certifications and promotes a well-balanced lifestyle that includes professional networking opportunities. How you will make an impact: * Analyzes and interprets data and makes recommendations for change based on judgment and experience. * Able to work independently on assignments and under minimal guidance from the manager. * Prepare detailed work papers and present findings in accordance with Government Auditing Standards (GAS) and CMS requirements. * Gain experience with applicable Federal Laws, regulations, policies, and audit procedures. * Respond timely and accurately to customer inquiries. * Ability to multi-task while independently and effectively prioritizing work using time management, initiative, project management and problem-solving skills. * Must be able to perform all duties of lower-level positions as directed by management. * Participates in special projects and review of work done by auditors as assigned. * Assist in mentoring less experienced associates as assigned. * Perform complex cost report desk reviews. * Perform complex cost report audits, serving as an in-charge auditor assisting other auditors assigned to the audit. * Dependent upon experience, may perform supervisory review of work completed by other associates. * Analyze and interpret data per a provider's trial balance, financial statements, financial documents, or other related healthcare records. Minimum Requirements: * Requires a BA/BS degree and a minimum of 5 years of audit/reimbursement or related Medicare experience; or any combination of education and experience, which would provide an equivalent background. * This position is part of our NGS (National Government Services) division which, per CMS TDL 190275, requires foreign national applicants meet the residency requirement of living in the United States at least three of the past five years. Preferred Skills, Capabilities, and Experiences: * Degree in Accounting preferred. * Knowledge of CMS program regulations and cost report format preferred. * Knowledge of CMS computer systems and Microsoft Office Word and Excel strongly preferred. * MBA, CPA, or CIA preferred. * Must obtain Continuing Education Training requirements (where required). * A valid driver's license and the ability to travel may be required. If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a 'sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $61,560 to $102,060 Locations: Maryland, Minnesota, Nevada, and New York In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Audit & Reimbursement III Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. * Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. National Government Services is a proud member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The Audit and Reimbursement III will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health and Human Services). Under guided supervision, the Audit and Reimbursement III will gain experience on complex issues involving the Medicare cost report and Medicare Part A reimbursement. They will participate in contractual Audit and Reimbursement workload, and have opportunities to participate on special projects. This position provides a valuable opportunity to gain further experience in auditing and financial analysis within a growing healthcare industry. This position allows for educational opportunities leading to certifications and promotes a well-balanced lifestyle that includes professional networking opportunities. How you will make an impact: * Analyzes and interprets data and makes recommendations for change based on judgment and experience. * Able to work independently on assignments and under minimal guidance from the manager. * Prepare detailed work papers and present findings in accordance with Government Auditing Standards (GAS) and CMS requirements. * Gain experience with applicable Federal Laws, regulations, policies and audit procedures. * Respond timely and accurately to customer inquiries. * Ability to multi-task while independently and effectively prioritizing work using time management, initiative, project management and problem-solving skills. * Must be able to perform all duties of lower-level positions as directed by management. * Participates in special projects and review of work done by auditors as assigned. * Assist in mentoring less experienced associates as assigned. Job specific functions for Reopening Team: * Review Medicare cost report re-openings initiated from provider requests, CMS requests, or by the MAC * Perform level 1 or level 2 audit review as part of the reopening process on all areas of the Medicare cost report such as Medicare DSH, Bad Debts, IME/DGME, NAH, Organ Acquisition and all cost based principles * Analyze and interpret data per a provider's trial balance, financial statements, financial documents or other related healthcare records * Actively participate in development of Audit & Reimbursement standard operating procedures * Activity participate in workgroup initiatives to enhance quality, efficiency and training Minimum Requirements: * Requires a BA/BS degree and a minimum of 5 years of audit/reimbursement or related Medicare experience; or any combination of education and experience, which would provide an equivalent background. * This position is part of our NGS (National Government Services) division which, per CMS TDL 190275, requires foreign national applicants meet the residency requirement of living in the United States at least three of the past five years. Preferred Skills, Capabilities and Experiences: * Degree in Accounting or Finance preferred. * Knowledge of CMS program regulations and cost report format preferred. * Knowledge of CMS computer systems and Microsoft Office Word and Excel strongly preferred. * MBA, CPA or CIA preferred. * Must obtain Continuing Education Training requirements (where required). * A valid driver's license and the ability to travel may be required. If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a 'sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $61,560 to $102,060 Locations: Maryland, Minnesota, Nevada, and New York In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Audit & Reimbursement III- Medicare Cost Report Audit Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. National Government Services is a proud member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The Audit and Reimbursement III will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health and Human Services). Under guided supervision, the Audit and Reimbursement III will gain experience on complex issues involving the Medicare cost report and Medicare Part A reimbursement. They will participate in contractual Audit and Reimbursement workload, and have opportunities to participate on special projects. This position provides a valuable opportunity to gain further experience in auditing and financial analysis within a growing healthcare industry. This position allows for educational opportunities leading to certifications and promotes a well-balanced lifestyle that includes professional networking opportunities. How you will make an impact: * Analyzes and interprets data and makes recommendations for change based on judgment and experience. * Able to work independently on assignments and under minimal guidance from the manager. * Prepare detailed work papers and present findings in accordance with Government Auditing Standards (GAS) and CMS requirements. * Gain experience with applicable Federal Laws, regulations, policies, and audit procedures. * Respond timely and accurately to customer inquiries. * Ability to multi-task while independently and effectively prioritizing work using time management, initiative, project management and problem-solving skills. * Must be able to perform all duties of lower-level positions as directed by management. * Participates in special projects and review of work done by auditors as assigned. * Assist in mentoring less experienced associates as assigned. * Perform complex cost report desk reviews. * Perform complex cost report audits, serving as an in-charge auditor assisting other auditors assigned to the audit. * Dependent upon experience, may perform supervisory review of work completed by other associates. * Analyze and interpret data per a provider's trial balance, financial statements, financial documents, or other related healthcare records. Minimum Requirements: * Requires a BA/BS degree and a minimum of 5 years of audit/reimbursement or related Medicare experience; or any combination of education and experience, which would provide an equivalent background. * This position is part of our NGS (National Government Services) division which, per CMS TDL 190275, requires foreign national applicants meet the residency requirement of living in the United States at least three of the past five years. Preferred Skills, Capabilities, and Experiences: * Degree in Accounting preferred. * Knowledge of CMS program regulations and cost report format preferred. * Knowledge of CMS computer systems and Microsoft Office Word and Excel strongly preferred. * MBA, CPA, or CIA preferred. * Must obtain Continuing Education Training requirements (where required). * A valid driver's license and the ability to travel may be required. If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a 'sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $61,560 to $102,060 Locations: Maryland, Minnesota, Nevada, and New York In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Audit & Reimbursement III Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. * Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. National Government Services is a proud member of Elevance Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs. The Audit and Reimbursement III will support our Medicare Administrative Contract (MAC) with the federal government (The Centers for Medicare and Medicaid Services (CMS) division of the Department of Health and Human Services). Under guided supervision, the Audit and Reimbursement III will gain experience on complex issues involving the Medicare cost report and Medicare Part A reimbursement. They will participate in contractual Audit and Reimbursement workload, and have opportunities to participate on special projects. This position provides a valuable opportunity to gain further experience in auditing and financial analysis within a growing healthcare industry. This position allows for educational opportunities leading to certifications and promotes a well-balanced lifestyle that includes professional networking opportunities. How you will make an impact: * Analyzes and interprets data and makes recommendations for change based on judgment and experience. * Able to work independently on assignments and under minimal guidance from the manager. * Prepare detailed work papers and present findings in accordance with Government Auditing Standards (GAS) and CMS requirements. * Gain experience with applicable Federal Laws, regulations, policies and audit procedures. * Respond timely and accurately to customer inquiries. * Ability to multi-task while independently and effectively prioritizing work using time management, initiative, project management and problem-solving skills. * Must be able to perform all duties of lower-level positions as directed by management. * Participates in special projects and review of work done by auditors as assigned. * Assist in mentoring less experienced associates as assigned. Job specific functions for Reopening Team: * Review Medicare cost report re-openings initiated from provider requests, CMS requests, or by the MAC * Perform level 1 or level 2 audit review as part of the reopening process on all areas of the Medicare cost report such as Medicare DSH, Bad Debts, IME/DGME, NAH, Organ Acquisition and all cost based principles * Analyze and interpret data per a provider's trial balance, financial statements, financial documents or other related healthcare records * Actively participate in development of Audit & Reimbursement standard operating procedures * Activity participate in workgroup initiatives to enhance quality, efficiency and training Minimum Requirements: * Requires a BA/BS degree and a minimum of 5 years of audit/reimbursement or related Medicare experience; or any combination of education and experience, which would provide an equivalent background. * This position is part of our NGS (National Government Services) division which, per CMS TDL 190275, requires foreign national applicants meet the residency requirement of living in the United States at least three of the past five years. Preferred Skills, Capabilities and Experiences: * Degree in Accounting or Finance preferred. * Knowledge of CMS program regulations and cost report format preferred. * Knowledge of CMS computer systems and Microsoft Office Word and Excel strongly preferred. * MBA, CPA or CIA preferred. * Must obtain Continuing Education Training requirements (where required). * A valid driver's license and the ability to travel may be required. If this job is assigned to any Government Business Division entity, the applicant and incumbent fall under a 'sensitive position' work designation and may be subject to additional requirements beyond those associates outside Government Business Divisions. Requirements include but are not limited to more stringent and frequent background checks and/or government clearances, segregation of duties principles, role specific training, monitoring of daily job functions, and sensitive data handling instructions. Associates in these jobs must follow the specific policies, procedures, guidelines, etc. as stated by the Government Business Division in which they are employed. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $61,560 to $102,060 Locations: Maryland, Minnesota, Nevada, and New York In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

A mid-sized corporation in Carlsbad is seeking a motivated Audit Associate to join the internal audit and finance team. This role is perfect for an accounting graduate looking to gain practical experience in evaluating business processes, internal controls, and financial accuracy in a corporate environment. The Audit Associate will assist the internal audit team in examining financial operations, assessing compliance, and providing insights that support management decision-making. This role requires critical thinking, attention to detail, and the ability to communicate findings effectively. Key Responsibilities + Assist in the execution of internal audit projects and assessments + Analyze financial data, operational procedures, and account reconciliations + Prepare and maintain audit workpapers in accordance with internal guidelines + Collaborate with departments to gather documentation and clarify procedures + Support the team with quarterly and annual internal audits + Identify process improvements and suggest risk mitigation strategies + Document findings and assist in reporting results to management Requirements + Bachelor's degree in Accounting, Finance, or related discipline + Interest in CPA or other accounting certifications preferred + Strong analytical, organizational, and problem-solving skills + Advanced Excel skills; familiarity with internal controls and compliance processes + Ability to work independently while collaborating with teams + Excellent written and verbal communication skills + Proactive mindset and willingness to learn Robert Half is the world's first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles. Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go. Download the Robert Half app (https://www.roberthalf.com/us/en/mobile-app) and get 1-tap apply, notifications of AI-matched jobs, and much more. All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information. © 2025 Robert Half. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking "Apply Now," you're agreeing to Robert Half's Terms of Use (https://www.roberthalf.com/us/en/terms) and Privacy Notice (https://www.roberthalf.com/us/en/privacy) .

The Program Integrity Auditor provides detailed analysis, identifies improper payments, recommends corrective action, and strives to mitigate risk through provider education and support. The primary purpose of this position is to audit provider records to ensure that services meet these regulatory standards. Alliance is contractually obligated to implement measures to ensure that services are provided, billed and reimbursed in accordance with rules, regulations, coverage policies, laws, and contract requirements. This position will allow the successful candidate to work a schedule that will be primarily remote. While there is no expectation of being in the office routinely, they will be required to come into the Alliance Office for business and team meetings as needed. Responsibilities & Duties Audit/Post-Payment Reviews Conduct routine and targeted post-payment audits of Medicaid and State funded providers to ensure that services are rendered and documented in accordance with established state and federal rules, regulations, policies, and terms of provider contractual agreements with the state Develop audit plans and tools based on the services to be audited Request and/or collect medical records, personnel records, policies/procedures, compliance plans, and other documents from providers based on audit plans Systematically and accurately collect, document, and store evidence Identify inappropriate billing and improper payments Document audit activities and findings in a detailed report Present audit results to leadership and Compliance Committee Attends appeal hearings to present and explain review findings Provider Enrollment Due Diligence Reviews Conduct reviews of newly enrolled providers to ensure eligibility, qualifications, and/or licensure requirements are met per state and federal rules, regulations, policies, and terms of provider contractual agreements with the state Regulatory Review/Research Diligently research clinical policies, administrative code, federal/state laws to assess for noncompliance Data Analytics Analyze data from a variety of sources, including but not limited to claims, authorizations, enrollment, grievances, prior audits/investigations, incident reports, policies/procedures, to inform decision making Utilize various MicroStrategy and Healthcare Fraud Shield reports data during the audit process Technical Assistance/Education Educates providers on the errors identified in the audit process Recognize when providers can improve through technical assistance (TA) rather than formal corrective action Recognize quality of care issues and make recommendations to appropriate entities/authorities Provider Action and Follow-Up Document Improper Payment Charts, Statements of Deficiency, provides feedback and technical assistance to providers as needed/requested, and follows up on provider corrective action, as applicable Prepare for and participate in provider appeal process and/or court hearings to explain and defend audit findings Travel Travel between Alliance offices, attending meetings on behalf of Alliance, participating in Alliance sponsored events, etc. may be required Travel to meet with members, providers, stakeholders, attend court hearings etc. is required Minimum Requirements Education & Experience Bachelor's degree in health care compliance, analytics, government/public administration, auditing, security management, criminal justice, or pre-law, from an accredited College/University and three (3) years of post-degree of experience in healthcare compliance, regulatory analysis, policy development, auditing, investigations, accreditation or any equivalent combination of related training and experience. Preferred: Health care industry and/or Medicare/Medicaid/Behavioral Health knowledge Certification from AHFI, CFE, CPMA, CPC, CHC, or equivalent CLEAR Certified Investigator (Basic and Specialized) Clinical license as an LCSW, LCMHC, LMFT, LCAS, or LPA Knowledge, Skills, & Abilities Knowledge of the Alliance Health service benefit plans and network providers Knowledge of Health care industry and/or Medicare/Medicaid/Behavioral Health knowledge Knowledge of the state and federal Medicaid laws, state and federal criminal and civil fraud laws, regulations, policies, rules, guidelines, service limitations, and various Medicaid programs Knowledge and proficiency in claims adjudication standards & procedures A general understanding of all major MCO functions, in particular as it relates to prior authorization, utilization reviews, grievance management, provider credentialing and monitoring High degree of integrity and confidentiality required handling information that is considered personal and confidential Salary Range $32.80 - $41.82/ Hourly Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity An excellent fringe benefit package accompanies the salary, which includes: Medical, Dental, Vision, Life, Long Term Disability Generous retirement savings plan Flexible work schedules including hybrid/remote options Paid time off including vacation, sick leave, holiday, management leave Dress flexibility

**Category :** **Compliance** **About TP** **TP is a global, digital business services company. We deliver the most advanced, digitally powered business services to help the world's best brands streamline their business in meaningful and sustainable ways.** **With more than 500,000 inspired and passionate people speaking more than 300 languages, our global scale and local presence allow us to be a force of good in supporting our communities, our clients, and the environment.** **Benefits of working with TP include:** + **Paid Training** + **Competitive Wages** + **Full Benefits (Medical, Dental, Vision, 401k and more)** + **Paid Time Off** + **Employee wellness and engagement programs** **TP and You** **Through a balanced high-tech and high-touch approach blended with deep industry and geographic expertise, we make people's lives simpler, faster, and safer. We help companies adapt quickly to changing needs, and are inspired to deliver only the best in all that we do. You will become a key contributor in making that happen.** **Did you know that our Chief Client Officer started her career at TP as an agent and advanced to the pinnacle of the company? At TP, the sky is the limit!** **Purpose** **Gaming Compliance Auditor, Online Gaming Ensures the implementation of short to medium term activities within the function in line with the country, regional or global strategy. It is a specialized role that ensures all platform operations strictly adhere to legal, regulatory, and ethical standards across multiple jurisdictions. This position involves direct leadership in risk management, while collaborating with licensing analysts to manage complex regulatory requirements and embedding customer experience (CX) principles into the operational framework.** **This position is 100% work at home. While this position will be working from home, this candidate must be located within the US and be eligible to work in the US without sponsorship.** **This position requires occasional travel to the** **_Lima, Peru_** **location up to 4x per year. This person must have an active passport.** **Your Responsibilities** **_Operational Leadership & Customer Experience (CX):_** + **CX-Driven Compliance:** **Lead the integration of customer experience best practices into compliance workflows. Ensure that regulatory requirements are implemented in a user-friendly manner that minimizes player friction points without compromising security or legal obligations.** + **Player Journey Optimization:** **Analyze the player journey through a compliance lens, identifying areas where regulatory checks can be streamlined to improve engagement and retention while remaining compliant.** + **Customer Support Collaboration:** **Work closely with the Customer Support management team to ensure all player interactions regarding compliance issues (account verification, self-exclusion, AML inquiries) are handled efficiently, transparently, and with a player-first mindset.** + **Training & Communication:** **Ensure customer-facing staff are trained on how to communicate regulatory requirements effectively and empathetically to players.** **_Regulatory Oversight & Licensing Collaboration:_** + **Primary Regulatory Liaison:** **Serve as the main point of contact for external regulatory bodies, managing all direct inquiries and audits.** + **Licensing Collaboration:** **Collaborate closely with Gaming Licensing Analysts to facilitate the preparation, submission, and maintenance of all operator and key person license applications and renewals. Provide necessary data, documentation, and strategic input to support the analysts in their processes.** + **Regulatory Monitoring:** **Proactively monitor and interpret changes in online gaming laws and standards, updating internal policies and operational procedures accordingly.** + **Oversee and monitor Gaming Licensing Analysts' calls to ensure accuracy, compliance, and professionalism.** + **Serves as a coach and mentor on the area internally.** + **Develops policies, processes & standards that support the implementation of short to medium term tactical direction.** **_Risk Management & Internal Controls:_** + **AML & Fraud Prevention:** **Oversee and enforce Anti-Money Laundering (AML) and financial compliance requirements. Coordinate with fraud and security teams to manage customer risk profiles and ensure proper reporting.** + **Internal Controls & Auditing:** **Develop, implement, and maintain rigorous internal controls and Standard Operating Procedures (SOPs) to meet regulatory standards. Coordinate and facilitate internal and external audits.** + **Responsible Gaming:** **Manage and monitor the platform's Responsible Gaming program, ensuring strict adherence to player protection measures.** **Qualifications** + **Experience** **:** + **Expert with superior knowledge and experience within a specific area of expertise.** + **Proven experience (5 years) in a dedicated compliance, risk management, or legal role within the online gaming/iGaming industry is essential.** + **Demonstrated experience managing regulatory relationships and leading audit processes.** + **Contributes and recommends operational strategies and plans with direct impact on the organization.** + **Experience collaborating with licensing teams or analysts on submission processes.** + **Education** **: A bachelor's degree in a relevant field such as Business, Law, or a related discipline is typically required.** + **Core Skills** **:** + **Regulatory Expertise** **: Deep and comprehensive knowledge of online gaming laws, regulations, and reporting requirements across various jurisdictions.** + **Strategic Thinking** **: Ability to bridge the gap between compliance requirements and business operational goals, focusing on sustainable growth and customer loyalty.** + **Collaboration** **: Strong ability to work effectively with specialist teams, such as licensing analysts, IT, and customer support, to achieve common goals.** + **Communication & Empathy** **: Excellent communication skills for liaising with regulators, team members, and players.** + **Licensing & Certifications** **:** + **Ability to obtain and maintain a personal gaming license through relevant regulatory bodies.** + **Relevant compliance certifications are highly valued (e.g., Certified Anti-Money Laundering Specialist (CAMS))** + **Travel** + **Must be willing to commit to international travel within the Americas for regulatory meetings, audits, and compliance engagements.** + **Must hold a valid passport to facilitate international travel.** **Soft Skills** + **Process Excellence** + **Collaboration** + **Communication** + **Emotional Intelligence** + **Open-Mindedness** + **Critical Thinking** + **Solution Orientation** + **Entrepreneurship** + **AI Proficiency** + **Data Literacy** **Be Part of Our TP Family** **It is our mission to always provide an environment where our employees feel valued, inspired, and supported, so that they can bring their best selves to work every day. We believe that when employees are happy and healthy, they are more productive, creative, and engaged. We are committed to providing a workplace that is conducive to happiness and a healthy work-life balance. We also believe that to be our best selves, we need to be surrounded by people who are positive, supportive, and challenging. We are committed to creating a culture of inclusion and diversity, where everyone feels welcome and valued.** **TP is an Equal Opportunity Employer**

As CohnReznick grows, so do our exceptional career opportunities. As one of the nation's top professional services firms, CohnReznick creates rewarding careers in advisory, assurance, and tax with team members who value innovation and collaboration in everything they do! CohnReznick helps organizations optimize performance, manage risk, and maximize value through CohnReznick LLP (assurance services) and CohnReznick Advisory LLC (advisory and tax services). Together, the firm provides leaders with deep industry knowledge and relationships, solutions to address clients' unique business goals and risks, and insight on how emerging market forces can drive opportunity. With offices nationwide, the firm serves organizations around the world as an independent member of Nexia. We currently have an exciting career opportunity on our Audit teams in our Los Angeles office for Fall 2027. Most CohnReznick professionals live within commuting distance of an office. This position is considered hybrid, which means team members are expected to be thoughtful and intentional in how they create opportunities for in-person collaboration. While the cadence of in-office presence is determined at the team level, our professionals are encouraged to be in the office/together in person on average 3 days a week. YOUR TEAM. Engagement Team: You will work closely on a team made up of other Interns, Associates, Senior Associates, Managers, Senior Managers, and Partners Industries: We serve a variety of clients across industries, including: Consumer & Industrial, Financial Sponsors & Financial Services, Life Sciences & Healthcare, Public Sector, Real Estate, Renewable Energy, Technology & Media, and Private Client Services (varies by office) Office: Our CohnReznick office comes with amenities and collaborative spaces. Performance Coach: Will meet with you to establish goals, provide feedback and support to guide you along your career path of choice; many of our current Senior Managers and Partners were once CR Associates themselves. CR Friend: Will serve as a familiar face when you join the firm and someone you can always reach out to WHY COHNREZNICK? At CohnReznick, you'll join a team committed to helping you grow professionally, offering opportunities to build skills, collaborate, and make a meaningful impact throughout your career journey. We believe it's important to balance work with everyday life - and make time for enjoyment and fun. We invest in a robust Total Rewards package that includes everything from generous PTO, a flexible work environment, expanded parental leave, extensive learning & development, and even paid time off for employees to volunteer. YOUR ROLE. As an Audit Associate, you will be responsible for becoming familiar with accounting and auditing procedures and performing procedures in accordance with firm standards in an accurate, thorough, and timely manner. Responsibilities include but not limited to: Responsible for assisting in areas of Audits, Reviews, Compilations, and Accounting Services. Work on a variety of client deliverables and preparing work papers. Resolve audit issues obtaining evidence and making inquiries of clients. Understand the client's accounting systems. Understand and apply concepts of materiality and audit risk. Prepare work papers that are informative, well documented, cross-referenced, and can easily be understood and explained. YOUR EXPERIENCE. We are looking for highly dedicated professionals with impressive credentials that are driven by new challenges and growth opportunities. We seek team players who believe in providing world-class client service and are interested in becoming immersed in various industries. Successful team members are looking for a work environment that values and promotes camaraderie, collaboration and giving back to the community. The successful candidate will have: Bachelor's or Master's Degree in Accounting Plan to complete 150 credit hours by September 2027 in order to be CPA licensed Minimum GPA of 3.2 in both your major and overall Leadership positions in extracurricular activities are preferred Prior work or internship experience (experience in accounting is a plus) Exhibit excellent communication skills and demonstrate sharp critical thinking Comfortable navigating fast-paced environments and embracing change Must have advanced skills in Excel, PowerPoint, and eager to learn new technologies Must be a U.S. citizen or permanent resident In addition, please take a moment to review our Universal Job Standards. In Los Angeles, the salary for an Associate is $81,000. Salary is one component of the CohnReznick total rewards package, which includes a discretionary performance bonus, generous paid time off, expanded, inclusive parental benefits, and access to best-in-class learning and development platforms. To learn more about life at CohnReznick, visit Life at CohnReznick. "CohnReznick" is the brand name under which CohnReznick LLP and CohnReznick Advisory LLC and their respective subsidiaries provide professional services. CohnReznick LLP and CohnReznick Advisory LLC (and their respective subsidiaries) practice in an alternative practice structure in accordance with the AICPA Code of Professional Conduct and applicable law, regulations, and professional standards. CohnReznick LLP is a licensed CPA firm that provides attest services to its clients. CohnReznick Advisory LLC provides tax and business consulting services to its clients. CohnReznick Advisory LLC and its subsidiaries are not licensed CPA firms. CohnReznick is an equal opportunity employer, committed to a diverse and inclusive team to drive business results and create a better future every day for our team members, clients, partners, and communities. We believe a diverse workforce allows us to match our growth ambitions and drive inclusion across the business. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, age, national origin, or protected veteran status and will not be discriminated against on the basis of disability. For more information, please see Equal Employment Opportunity Posters. If you are an individual with a disability in need of assistance at any time during our recruitment process, please contact us at CRaccommodation@cohnreznick.com. Please note: This email address is reserved for individuals with disabilities in need of assistance and are not a means of inquiry about positions or application statuses. CohnReznick does not accept unsolicited resumes from third-party recruiters unless such recruiters are currently engaged by CohnReznick Talent Acquisition Team by way of a written agreement to provide candidates for a specified opening. Any employment agency, person or entity that submits an unsolicited resume does so with the understanding that CohnReznick will have the right to hire that applicant at its discretion without any fee owed to the submitting employment agency, person or entity. #GD

Audit Associate - Los Angeles , CA - Class of 2027 As CohnReznick grows, so do our exceptional career opportunities. As one of the nation's top professional services firms, CohnReznick creates rewarding careers in advisory, assurance, and tax with team members who value innovation and collaboration in everything they do! CohnReznick helps organizations optimize performance, manage risk, and maximize value through CohnReznick LLP (assurance services) and CohnReznick Advisory LLC (advisory and tax services). Together, the firm provides leaders with deep industry knowledge and relationships, solutions to address clients' unique business goals and risks, and insight on how emerging market forces can drive opportunity. With offices nationwide, the firm serves organizations around the world as an independent member of Nexia. We currently have an exciting career opportunity on our Audit teams in our Los Angeles office for Fall 2027 . Most CohnReznick professionals live within commuting distance of an office. This position is considered hybrid, which means team members are expected to be thoughtful and intentional in how they create opportunities for in-person collaboration. While the cadence of in-office presence is determined at the team level, our professionals are encouraged to be in the office/together in person on average 3 days a week. YOUR TEAM. * Engagement Team: You will work closely on a team made up of other Interns, Associates, Senior Associates, Managers, Senior Managers, and Partners * Industries: We serve a variety of clients across industries, including: Consumer & Industrial, Financial Sponsors & Financial Services, Life Sciences & Healthcare, Public Sector, Real Estate, Renewable Energy, Technology & Media, and Private Client Services (varies by office) * Office: Our CohnReznick office comes with amenities and collaborative spaces. * Performance Coach: Will meet with you to establish goals, provide feedback and support to guide you along your career path of choice; many of our current Senior Managers and Partners were once CR Associates themselves. * CR Friend: Will serve as a familiar face when you join the firm and someone you can always reach out to WHY COHNREZNICK? At CohnReznick, you'll join a team committed to helping you grow professionally, offering opportunities to build skills, collaborate, and make a meaningful impact throughout your career journey. We believe it's important to balance work with everyday life - and make time for enjoyment and fun. We invest in a robust Total Rewards package that includes everything from generous PTO, a flexible work environment, expanded parental leave, extensive learning & development, and even paid time off for employees to volunteer. YOUR ROLE. As an Audit Associate, you will be responsible for becoming familiar with accounting and auditing procedures and performing procedures in accordance with firm standards in an accurate, thorough, and timely manner. Responsibilities Include But Not Limited To * Responsible for assisting in areas of Audits, Reviews, Compilations, and Accounting Services. * Work on a variety of client deliverables and preparing work papers. * Resolve audit issues obtaining evidence and making inquiries of clients. * Understand the client's accounting systems. * Understand and apply concepts of materiality and audit risk. * Prepare work papers that are informative, well documented, cross-referenced, and can easily be understood and explained. Your Experience. We are looking for highly dedicated professionals with impressive credentials that are driven by new challenges and growth opportunities. We seek team players who believe in providing world-class client service and are interested in becoming immersed in various industries. Successful team members are looking for a work environment that values and promotes camaraderie, collaboration and giving back to the community. The Successful Candidate Will Have * Bachelor's or Master's Degree in Accounting * Plan to complete 150 credit hours by September 2027 in order to be CPA licensed * Minimum GPA of 3.2 in both your major and overall * Leadership positions in extracurricular activities are preferred * Prior work or internship experience (experience in accounting is a plus) * Exhibit excellent communication skills and demonstrate sharp critical thinking * Comfortable navigating fast-paced environments and embracing change * Must have advanced skills in Excel, PowerPoint, and eager to learn new technologies * Must be a U.S. citizen or permanent resident In addition, please take a moment to review our Universal Job Standards . In Los Angeles , the salary for an Associate is $81,000. Salary is one component of the CohnReznick total rewards package, which includes a discretionary performance bonus, generous paid time off, expanded, inclusive parental benefits, and access to best-in-class learning and development platforms. To learn more about life at CohnReznick, visit Life at CohnReznick . "CohnReznick" is the brand name under which CohnReznick LLP and CohnReznick Advisory LLC and their respective subsidiaries provide professional services. CohnReznick LLP and CohnReznick Advisory LLC (and their respective subsidiaries) practice in an alternative practice structure in accordance with the AICPA Code of Professional Conduct and applicable law, regulations, and professional standards. CohnReznick LLP is a licensed CPA firm that provides attest services to its clients. CohnReznick Advisory LLC provides tax and business consulting services to its clients. CohnReznick Advisory LLC and its subsidiaries are not licensed CPA firms. CohnReznick is an equal opportunity employer, committed to a diverse and inclusive team to drive business results and create a better future every day for our team members, clients, partners, and communities. We believe a diverse workforce allows us to match our growth ambitions and drive inclusion across the business. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, age, national origin, or protected veteran status and will not be discriminated against on the basis of disability. For more information, please see Equal Employment Opportunity Posters . If you are an individual with a disability in need of assistance at any time during our recruitment process, please contact us at CRaccommodation@cohnreznick.com . Please note: This email address is reserved for individuals with disabilities in need of assistance and are not a means of inquiry about positions or application statuses. CohnReznick does not accept unsolicited resumes from third-party recruiters unless such recruiters are currently engaged by CohnReznick Talent Acquisition Team by way of a written agreement to provide candidates for a specified opening. Any employment agency, person or entity that submits an unsolicited resume does so with the understanding that CohnReznick will have the right to hire that applicant at its discretion without any fee owed to the submitting employment agency, person or entity. #GD

A client with Kforce is seeking a Associate Internal Audit II to join their team in Los Angeles, CA. In this role, the Associate Internal Audit will work within a team and on occasion as an individual contributor on routine audit assignments testing internal controls and ensuring compliance with bank policies, procedures, and regulatory requirements. Responsibilities: * Complies fully with all Bank Operational and Credit policies and procedures as well as all regulatory requirements (e.g. Bank Secrecy Act, Know Your Client, Community Reinvestment Act, Fair Lending Practices, Code of Conduct, etc.) * Develops a general knowledge of the business, regulatory and accounting and control environment in which the client operates * Keeps informed of new services, products and events that have a significant technology and business impact * Assists the Senior Auditor and or Audit Manager in the development of the audit scope * Holds preliminary discussions and interviews with auditees prior to the beginning of the field work * Prepares narratives/flowcharts detailing internal controls of area audited * Documents the workflow in the area audited, develops audit programs or procedures, and updates audit programs as necessary * Performs program procedures and documents work performed, test results and conclusions using work paper preparation guidelines * Holds discussions/interview with auditee to gather information, obtains explanations and supporting data/information and documents audit findings and the conclusions drawn * Keeps the Senior Auditor and/or Audit Manager abreast of progress, issues and audit matters as they arise * Contributes to the drafting of audit observation sheets and audit reports * Supports and or participates in audit exit meeting with management* Bachelor's degree or equivalent * 3+ years of experience in performing internal control audits and risk assessments required * Prior financial services industry experience, preferably banking * Understanding of risks, internal controls, work paper documentation and issue identification concepts and experience in applying them to plan, perform, and report on the evaluation of various business processes/areas/functions * Ability to work independently or under the guidance and supervision of a Senior Auditor * Strong verbal and written communication skills, to effectively present to peers and management * Ability to exhibit leadership skills needed to convey ideas and obtain management buy-in for constructive change * Understanding of internal auditing standards, COSO and risk assessment practices * Understanding of the technical aspects of accounting and financial reporting * Experience in performing multiple projects and working with varying team members

+ **Shift Hours: 6-4:30 PM PST+ OT as needed.** + Responsible for the final quality audit before shipment of systems, upgrades, and miscellaneous ship kits. + Collaborate closely with Manufacturing, Manufacturing Engineering, Master Scheduling, Production Control, Material handlers, Dock personnel and Packing contractors to ensure audits and quality inspections are completed so that products ship on time. + Demonstrate proficiency with SAP SW as well as the MS Office suite. + Clear communication and strong collaborative skills + Persevere against challenging and time constrained issues. + Inventing creative solutions to problems to ensure the job gets done on time. + Provide constructive process improvement recommendations. + Redline procedures as appropriate. + Assist in the training and development of new hires. + Support other product lines in plant clearance activities when necessary. **Responsibilities:** + Auditing material against BOMs. + Evaluating the quality of packaging. + Visual spot check of part quality. + Ensure proper labelling of parts. + Consolidating piece parts into the correct shipping bin. + Working with Production Control and/or Manufacturing Engineering to resolve issues. + Coordinate material movement out of clean room. + Creating and maintaining Plant Clearance audit records. **Experience:** + Quality Control exp. for Packaging & Production audits for semiconductor or manufacturing clients **Skills:** + Auditing material against BOMs + Quality Control + SAP SW + MS Office suite **Education:** + HS or equivalent practical experience. **About US Tech Solutions:** US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit *********************** . US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Your Role The Internal Audit Services team performs internal audits and advisory services to provide assurance on specific internal control objectives and emerging risk areas. The Internal Audit Principal will report to the Internal Audit Senior Director. In this role, you will be leading and managing financial, operational, and integrated audits and advisory engagements. You will also be assessing the design and effectiveness of internal controls for business processes, financial reporting and measurement activities, and related applications in accordance with laws, regulations, policies, standards, and procedures using established tools and techniques. Your Knowledge and Experience Requires a bachelor's degree or equivalent experience Requires a minimum of 10 years of prior related experience Ability to communicate with executive leadership regarding matters of significant importance to the organization Extensive understanding of internal controls and the ability to leverage this knowledge to make effective audit and advisory recommendations Internal audit and risk assessment practices and methodologies. IT general and automated technical controls concepts, application controls and end-user computing controls. AI and data analysis techniques preferred Healthcare and pharmacy audit experience preferred Certified Internal Auditor (CIA) and/or Certified Information Systems Auditor (CISA) preferred Your Work In this role, you will: Execute the annual audit plan by independently performing audit procedures, including identifying and defining issues, developing criteria, reviewing, and analyzing evidence, and documenting management processes and procedures. Audits entail end to end process reviews, can be cross functional and complex. Provide expertise in internal controls including project management, business process analysis, financial control disciplines, and information technology Implement strategic goals established by Internal Audit Services leadership Support Internal Audit management is the annual risk assessment process to develop the annual audit plan Identify, develop, and document audit issues and recommendations using independent judgment concerning areas being reviewed Prepares and delivers reports and presentations to various levels of management Performs post-audit follow-up reviews to ensure management corrective action plans have been effectively implemented Provides measurable input into new products, processes, standards, and/or operational plans that impact Internal Audit Services, and proactively improves upon existing processes and systems using significant conceptualizing, reasoning, and interpretation Conducts extensive investigation and critical thinking to understand root causes of problems that span a wide range of difficult and unique issues across functions and/or businesses Manages large, complex project initiatives of strategic importance to the organization, involving large cross-functional teams. May direct the work of other individual contributors and/or act as a cross-functional team lead

Your Role The Quality Review team completes audits of front-line staff to ensure alignment with department processes and regulatory compliance. Clinical Quality Auditors also provide coaching and work closely with business leaders to drive optimal results. The Clinical Quality Auditor, Consultant will report to the Quality Review Senior Manager. In this role you will develop performance metrics, evaluate performance, and provide coaching to ensure that staff have the skills and knowledge required to be successful in Population Health Management and Utilization Management. Your Knowledge and Experience Requires a Bachelor's of Science in Nursing or advanced degree preferred Current California RN license required At least 7 years of experience in managed care or similar complex healthcare environment with a minimum of 1 year experience in Case Management required Auditing experience preferred Population Health Management and Utilization Management experience preferred Strong organizational and/or project management skills to coordinate departmental projects and to perform multiple projects or tasks simultaneously Subject matter expert with capability to effectively audit and train all lines of business (Commercial, Federal Employee Program, Medicare, and Medi-Cal) Your Work In this role, you will: Perform audits for Population Health Management (PHM) and Care Coordination adhering to monthly productivity and quality metrics. Review audit data to identify care gaps, compliance risks, and trends. Communicate findings to leadership and provide recommendations to mitigate risks. Design, implement, evaluate and improve audit criteria and coaching strategies to meet the needs of PHM clinical staff. Provide developmental coaching and support to all staff to improve the skills and competencies required to successfully perform work. Conduct effective presentations relating to PHM processes and/or regulatory compliance for clinical staff. May independently represent the Quality Review department in PHM and work re-design, process changes and software implementation. Act as a resource for the training and auditing team

**Start/end time: 7:00 am to 3:30 pm** **Shift : Day** The Claims Auditor assists in the Claims Department by analyzing procedures, policies and reports; ensures appropriate payment of claims and maintenance of the claims system as necessary. **SPECIFIC SKILLS NEEDED** Knowledge of HMO/or IPA operations; medical terminology; ICD-10, RVS, and CPT coding knowledge; knowledge of Medicare and Medi-Cal guidelines; 10-key skills by touch; excellent communication skills; knowledge of system applications; ability to function effectively under time deadlines; strong organizational skills. **Required:** Formal training will be indicated by a high school diploma or equivalent; four years medical claims processing. **Preferred:** -Department Management to list. **DUTIES AND RESPONSIBILITIES** 1.Safeguards and preserves the confidentiality of patient's protected health information in accordance with State and Federal (HIPAA) regulatory requirements, hospital and departmental policies. 2.Ensures a safe patient environment and adherence to safety practices per policy. 3.With consideration to age, employee utilizes the approved process to resolve biophysical, psychological, educational and environmental needs of patient/significant other when administering care. 4.Assist the Claims Director in the training and education of the Claims department staff 5.Coordinate the generation and review of claims audit, status and pending claims reports ensuring authorized claims are paid in accordance with company guidelines 6.Investigate, process and track payment adjustments including refunds, overpayments and underpayments 7.Act as a confidential and professional resource for group providers and other staff. 8.Act as a resource for providers, members, insurance carriers, attorneys and co-workers, researching and responding to questions in a timely manner 9.Create, maintain and generate system reports 10.Interface with the Claims Director to ensure claims processing functions meet legal and contractual requirements with regards to health plan audits 11.Prepare and present weekly and monthly reports reflecting staff and departmental quality statistics 12.Review and audit member liability denials and Provider Dispute Resolution claims to ensure compliance with regulatory requirements and passing audit scores from health plans 13.Perform other duties as assigned **TEAMWORK/CUSTOMER SERVICE RESPONSIBILITIES** 1.Customer Service Values and Behaviors: 1.1 Value :Each person is treated with respect, dignity, fairness and compassion. Behavior: Performance is acceptable when everyone is promptly greeted with a smile in a warm and caring manner using the person's name whenever possible. No matter how I feel, I display a caring attitude. 1.2 Value: Each person displays loyalty and pride in and upholds the confidentiality of patients, visitors, physicians, and co-workers. Behavior: Performance is acceptable when concerns/problems with fellow employees and customers are not discussed with anyone other than the person involved or the supervisor. Customer issues and ideas are listened to and appropriate follow up occurs to create a satisfied customer. I do not make excuses. I do not demean other people or departments. 1.3 Value:Each person demonstrates commitment to open communication. Behavior: Performance is acceptable when openness and acceptance of constructive criticism occurs. Positive communication occurs by complimenting and expressing appreciation to others. I will listen and encourage others to express ideas and opinions. 1.4 Value: Each person demonstrates pride in the physical appearance of all properties. Behavior: Performance is acceptable when the initiative is taken to maintain a clean and safe environment. I conduct myself in a manner which respects and preserves equipment and the physical plant. I do not walk by spills, trash or unsafe conditions without assuring that they are attended to promptly by me or appropriate personnel. **PERSONAL QUALITIES** -Department Management to list. **COMMUNICATION** -Talking or hearing essential to communicate with patients and staff. -Good communication skills; read, speaks and writes English fluently. -Bilingual skills in Spanish/Chinese preferred About US Tech Solutions: US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit ************************ US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.