Coding Auditor Educator
Auditor Job In Dover, DE
Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants regarding billing, coding and/or documentation and evaluates their recommendations and/or teaching plans in accordance with federal and state regulations and guidelines
**ESSENTIAL RESPONSIBILITIES:**
+ Plans and \conducts audits and reports on the documentation, coding and billing performed at AHN entities. Reviews, develops and delivers training programs and educational materials to address deficiencies identified in the audits compliant with regulatory requirements. Provides written audit guidance. Participates with management in the assessment of external audit findings and responds as needed. Attends meetings and interacts with management to resolve issues and provide advice on new programs. Provides guidance to system entities in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine appeal action, prepare appeal letter follow up and identify education issues. (20%)
+ Develops audit detail summary spreadsheets and reports to address any coding, documentation, financial impact and profitability. Conducts education/training or works with external resources to present final audit findings to department staff, physicians and appropriate individuals. (20%)
+ Validates the ICD-CM, ICD-PCS, CPT and HCPCS Level II code and modifier systems, missed secondary diagnoses and procedures and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim form reviews to check code transfer accuracy from the abstracting system and the chargemaster. (10%)
+ Is responsible for or works with external resources to create and monitor inpatient case mix reports and the top 25 assigned DRGs/APCs in the facilities to identify patterns, trends and variations in the facilities frequently assigned DRG/APC groups. Once identified, evaluate the cases of the change or problems and takes appropriate steps to effect resolution. (10%)
+ Reviews and interprets medical information, classifies that information into the appropriate payor specific groups consisting of ICD-CM ICD-PCS and CPT codes for diagnoses and procedures and calculates the DRG and APC. (10%)
+ Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and Corporate Compliance Coding Guidelines. Assures compliance with the coding guidelines and regulatory requirements. (10%)
+ Performs other duties as assigned or required including training/mentoring of new staff, performing audits and research related to special projects and providing coverage for coding manager(s). (10%)
+ Depending on location provides or arranges for education/training of facility healthcare professionals in use of coding guidelines and practices, proper documentation techniques, medical terminology and disease processes as it relates to the DRG/APC and other clinical data quality management factors. With technical direction and assistance from management, designs and implements coder education program, continuing education programs and Medical Staff education programs. Establishes and monitors performance and maintains appropriate documentation thereof. (10%)
+ Other duties as assigned.
**QUALIFICATIONS:**
Minimum
+ High school diploma / GED
+ Certification from American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA)
+ AHIMA Credentials (Inpatient or Outpatient): Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS)
+ AAPC Credentials (Outpatient): Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA)
+ 5 years with hospital or physician coding and/or auditing, as well as, education techniques and methods. (Internal transfer and promotion candidates may have a minimum of 3 years experience)
+ In-depth knowledge of ICD CM, ICD PCS and CPT/HCPCS coding systems. Must be proficient in DRG/APC structure, National Correct Coding Initiatives, ICD CM/PCS Official Guidelines, Outpatient Prospective payment system and Coding Clinic references. Current working knowledge of encoder, grouper, abstracting and other related software.
+ Strong analytical and communication skills
Preferred
+ Associate's Degree
+ 3 years with claims processing and data management
+ Past auditing and strong education/training background in coding and reimbursement
**_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._
**_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._
_As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._
_Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._
**Pay Range Minimum:**
$25.85
**Pay Range Maximum:**
$40.18
_Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at *****************************
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J259988
DRG Coding Auditor
Auditor Job In Wilmington, DE
will work virtually. Alternate locations may be considered. The DRG CODING AUDITOR is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and its clients. Also responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding and DRG assignment accuracy. Specializes in review of DRG coding via medical record and attending physician's statement sent in by acute care hospitals on submitted DRG.
How you will make an impact:
* Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines and objectivity in the performance of medical audit activities.
* Draws on advanced ICD-10 coding expertise, clinical guidelines, and industry knowledge to substantiate conclusions.
* Utilizes audit tools and auditing workflow systems and reference information to make audit determinations and generate audit findings letters.
* Maintains accuracy and quality standards as set by audit management for the auditing concept, valid claim identification, and documentation purposes (e.g., letter writing).
* Identifies new claim types by identifying potential claims outside of the concept where additional recoveries may be available, such as re-admissions, Inpatient to Outpatient, and HACs.
* Suggests and develops high quality, high value concept and or process improvement and efficiency recommendations.
Minimum Requirements:
* Requires at least one of the following: AA/AS or minimum of 5 years of experience in claims auditing, quality assurance, or recovery auditing.
* Requires at least one of the following certifications: RHIA certification as a Registered Health Information Administrator and/or RHIT certification as a Registered Health Information Technician and/or CCS as a Certified Coding Specialist and/or CIC as a Certified Inpatient Coder.
* Requires 5 years of experience working with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG.
Preferred Skills, Capabilities and Experiences:
* BA/BS preferred.
* Experience with vendor based DRG Coding / Clinical Validation Audit setting or hospital coding or quality assurance environment preferred.
* Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies, billing validation criteria and coding terminology preferred.
* Knowledge of Plan policies and procedures in all facets of benefit programs management with heavy emphasis in negotiation preferred
For candidates working in person or remotely in the below location(s), the salary* range for this specific position is $95,172 to $149,556.
Locations: Colorado; Illinois; Maryland; Minnesota; Nevada
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. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
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.
DRG Coding Auditor
Auditor Job In Wilmington, DE
will work virtually. Alternate locations may be considered. The DRG CODING AUDITOR is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and its clients. Also responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding and DRG assignment accuracy. Specializes in review of DRG coding via medical record and attending physician's statement sent in by acute care hospitals on submitted DRG.
How you will make an impact:
* Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines and objectivity in the performance of medical audit activities.
* Draws on advanced ICD-10 coding expertise, clinical guidelines, and industry knowledge to substantiate conclusions.
* Utilizes audit tools and auditing workflow systems and reference information to make audit determinations and generate audit findings letters.
* Maintains accuracy and quality standards as set by audit management for the auditing concept, valid claim identification, and documentation purposes (e.g., letter writing).
* Identifies new claim types by identifying potential claims outside of the concept where additional recoveries may be available, such as re-admissions, Inpatient to Outpatient, and HACs.
* Suggests and develops high quality, high value concept and or process improvement and efficiency recommendations.
Minimum Requirements:
* Requires at least one of the following: AA/AS or minimum of 5 years of experience in claims auditing, quality assurance, or recovery auditing.
* Requires at least one of the following certifications: RHIA certification as a Registered Health Information Administrator and/or RHIT certification as a Registered Health Information Technician and/or CCS as a Certified Coding Specialist and/or CIC as a Certified Inpatient Coder.
* Requires 5 years of experience working with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG.
Preferred Skills, Capabilities and Experiences:
* BA/BS preferred.
* Experience with vendor based DRG Coding / Clinical Validation Audit setting or hospital coding or quality assurance environment preferred.
* Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies, billing validation criteria and coding terminology preferred.
* Knowledge of Plan policies and procedures in all facets of benefit programs management with heavy emphasis in negotiation preferred
For candidates working in person or remotely in the below location(s), the salary* range for this specific position is $95,172 to $149,556.
Locations: Colorado; Illinois; Maryland; Minnesota; Nevada
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.
Job Level:
Non-Management Exempt
Workshift:
1st Shift (United States of America)
Job Family:
MED > Licensed/Certified - Other
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. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
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.
Risk Adjustment Auditor I
Auditor Job In Dover, DE
Accountable for reviewing member records to accurately maximize risk scoring in keeping with Baylor Scott and White Health risk adjustment strategies and processes for lines of business subject to risk adjustment. **Salary Range:** The pay range for this position is $26.66/hr (entry-level qualifications) - $40/hr (highly experienced). The specific rate will depend upon the successful candidate's specific qualifications and prior experience.
**ESSENTIAL FUNCTIONS OF THE ROLE**
+ Conducts provider audits and creates provider scorecards to offer feedback on Risk Adjustment Methodology
+ Interprets health record documentation to code and abstracts diagnoses and/or procedures for inpatient, outpatient, and clinic cases
+ Conducts focused HCC reviews on providers and clinics, tracks results and identifies trends and deficiencies for follow-up
+ Researches complex coding HCC issues and keeps abreast of coding and compliance changes as communicated by CMS, HHS, AHA, AMA and the Federal Register, and sharing knowledge with co-workers, as directed
+ Assists Risk Adjustment Auditor 2 or Manager with educator duties in the clinics on occasional based, as needed
+ Protects data integrity and validity
+ Maintains and respects patient confidentiality for accessing and disclosure of health information
**KEY SUCCESS FACTORS**
+ Knowledge of ICD-10-CM and CPT coding conventions, and clinical documentation
+ Knowledge of and compliance with standards of ethical coding as set forth by the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC)
+ Knowledge of anatomy, physiology, pathological processes of disease, and medical terminology
+ Critical thinking skills for chart review and abstraction
+ Efficient Time Management skills
+ Proficiency in use of Microsoft applications such as Word, Excel, and PowerPoint preferred
**BENEFITS**
Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include:
+ Immediate eligibility for health and welfare benefits
+ 401(k) savings plan with dollar-for-dollar match up to 5%
+ Tuition Reimbursement
+ PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level
**QUALIFICATIONS**
+ EDUCATION - Associate's or 2 years of work experience above the minimum qualification
+ EXPERIENCE - 2 Years of Experience
**CERTIFICATION/LICENSE/REGISTRATION**
+ Cert Coding Specialist (CCS), Cert Coding Spec Physician Bas (CCS-P), Cert Professional Coder (CPC), Reg Health Info Administrator (RHIA), Reg Health Information Technic (RHIT): Must have one of the following:
+ CCS - Certified Coding Specialist
+ CCS-P - Certified Coding Specialist-Physician Based
+ CPC - Certified Professional Coder
+ RHIA - Reg Health Info Administrator
+ RHIT - Reg Health Information Technician.
As a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviours that we promote to our patients. As of January 1, 2012, Baylor Scott & White Health no longer hires individuals who use nicotine products. We are an equal opportunity employer committed to ensuring a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.
Auditor
Auditor Job In Wilmington, DE
Participates in all phases of the audits across their assigned projects. Assists in completion of annual risk assessments, continuous auditing, and remediation plan validations as assigned, under supervision of a Lead Auditor or Manager.
Primary Responsibilities:
Participate in audits by executing assigned tasks in accordance with the Division's methodology and professional standards. Complete work within the established timeframes with guidance by a Lead Auditor or Manager.
As part of audit execution, conduct effective walkthroughs, accurately identify risks and controls within the process, design and execute effective testing approach with guidance by a Lead Auditor or Manager.
Conduct effective root cause analysis of identified findings with guidance by a Lead Auditor or Manager.
Actively participate in meetings with business management and provide updates on their respective areas of testing.
Participate in other assurance activities (including continuous auditing, product delivery assessments, validation procedures, investigations, and retrospective reviews) under the supervision of a Lead Auditor or Manager, utilizing modernized assurance methodologies, tools, and approaches and in accordance with the Division's methodology.
Document the work, including findings, in clear and concise fashion in accordance with the Division's methodology.
Embrace innovative change.
Understand how to effectively incorporate data analytics.
Actively seek out knowledge in the areas of assigned audit activities.
Embrace the culture of diversity, inclusion, equity and belonging.
Understand and adhere to the Company's risk and regulatory standards, policies, and controls in accordance with the Company's Risk Appetite. Identify risk-related issues needing escalation to management.
Promote an environment that supports diversity and reflects the M&T Bank brand.
Maintain M&T internal control standards, including timely implementation of internal and external audit points together with any issues raised by external regulators as applicable.
Complete other related duties as assigned.
Scope of Responsibilities:
This individual is responsible for executing and documenting assigned assurance activities to support the delivery of audit reports that are in conformance with professional auditing standards. They report to an Audit (Senior) Manager.
Supervisory/Managerial Responsibilities:
Not Applicable
Education and Experience Required:
Bachelor's degree and a minimum of 2 years' work experience or successful completion of the MDP (Management Trainee program), or in lieu of degree, a combined minimum of 6 years' higher education and/or work experience, including a minimum of 2 years' work experience or successful completion of the MDP (Management Trainee program)
Proven analytical skills
Proven critical thinking skills
Effective verbal and written communication skills
Willingness to challenge the status quo and defend conclusions when challenged
Education and Experience Preferred:
Bachelor's degree in Accounting, Business, Finance, Technology, Cybersecurity, Mathematics, Statistics, or other related technical field
MBA or Master's degree in an appropriate field
Related professional certifications
Financial services experience
M&T Bank is committed to fair, competitive, and market-informed pay for our employees. The pay range for this position is $66,979.45 - $111,632.42 Annual (USD). The successful candidate's particular combination of knowledge, skills, and experience will inform their specific compensation.LocationWilmington, Delaware, United States of America
Auditor II, Philadelphia Region
Auditor Job In Malvern, PA
FM Approvals is an international leader in third-party testing and certification services. We test property loss prevention products and services-for use in commercial and industrial facilities-to verify they meet rigorous loss prevention standards of quality, technical integrity and performance. How? By employing a worldwide certification process that's backed by scientific research and testing, and over a century of experience.
The FM APPROVED mark is recognized and respected worldwide. Our certification instills confidence and commands respect in your marketplace.
**Summary:**
Mid-level auditor position within the Auditing and Quality Assurance department of FM Approvals. The role of the Quality Auditor II will be to independently schedule and conduct at customer location conformity assessment audits at predetermined frequencies. Audits include various manufacturers responsible for making products that carry the FM Approvals' certification mark. FM Approved products cover a wide range of electrical, fire protection, and building materials equipment.
Incumbent is expected to have a solid base of auditing experience and demonstrated proficiency in conducting FM Approvals conformity assessment audits independently. The work assigned to candidates will be well defined and implemented with limited supervision. The complexity and size of audit assignments will vary significantly but will be limited to non QSR FM Approvals audits. Decisions regarding the scope of work performed may be delegated to an individual in this position with oversight by supervisors or managers.
**Schedule & Location:**
This is a full-time position based out of the Malvern, PA office supporting regional customer locations within the Mid-Atlantic states (Delaware, Maryland, New Jersey, New York, Pennsylvania, Virginia, West Virginia, and District of Columbia). The role requires approximately 70% travel and 30% of travel may require overnight flexibility.
- Effectively perform audits and evaluate audit/test results, weighing the relevancy, accuracy, and perspective of conclusions against the accumulated audit/test evidence acquired during audits
- Consistently document relevant facts and information which support the work performed and conclusions drawn so other reviewers can follow the auditor's logic and methodology
- Accurately report on a wide variety of witness testing against defined criteria and do so such that the work is competently and efficiently performed in accordance with professional and FM Approvals standards
- Communicate audit results effectively, both verbally and in writing, such that they are persuasive, placed in the appropriate context, and well understood by the recipient
**Required Education:**
- Bachelor's Degree in Engineering or Science field
**Highly Preferred Education:**
- Hold an ASQ, RABQSA / Exemplar Global or equivalent Lead Auditor Certification
**Required Work Experience:**
- 5+ years of manufacturing process experience
- 5+ years of related quality assurance and quality auditing experience
- Tenured audit experience with demonstrated proficiency performing FM Approvals conformity assessment audits
**Highly Preferred Work Experience:**
- Process control experience is preferred
- ISO 9001, 17020, 17025 and/or 17065 experience
**Required Skills:**
- Possess a working knowledge of FM Approvals, its business processes, policies and procedures, governance practices, and regulatory obligations
- Demonstrate proficiency in applying audit principles, skills, and techniques of varying degrees of complexity
- Demonstrate effective time management skills by completing assignments within allocated time budgets and calendar schedules while handling multiple tasks
- Complete tasks independently, seeking guidance from senior auditors or management as needed
- Solid familiarity with concepts related to Approval/Certification/Quality Control Programs
- Excellent interpersonal, oral, and written communication skills
- Possess critical thinking, analytical and problem-solving skills
- Microsoft Office Suite computer literacy
- Ability to use and understand various measurement tools (pressure gauges, calipers, voltmeters, etc.)
- Ability to read, interpret and understand critical dimensions within engineering technical drawings
- Ability to take direction and work with minimal supervision
- Must be self-motivated with excellent organizational skills
- Ability to obtain and assess objective evidence throughout the audit while acting impartially
- Observe, document, and evaluate audit observations while effectively managing customer interactions during the audit process
The hiring range for this position is $72,160-$103,700 annually. The final salary offer will vary based on individual education, skills, and experience. The position is eligible to participate in FM's comprehensive Total Rewards program that includes an incentive plan, generous health and well-being programs, a 401(k) and pension plan, career development opportunities, tuition reimbursement, flexible work, time off allowances and much more.
FM is an Equal Opportunity Employer and is committed to attracting, developing, and retaining a diverse workforce.
Multiple positions for Auditor(GAAP Exp
Auditor Job In Wilmington, DE
We are from US IT Solutions, an ISO Certified, E-Verify, WMBE Certified organization established in 2005 in CA. Our company is serving various State, Local and County Departments for over 10 years. USITSOL has been helping clients innovate across all phases of the application lifecycle for over a decade. Some of our prestigious clients are State of CA, State of OR, State of FL, State of NC, State of GA, State of CO, State of VA, State of AR, State of MI, State of OH, State of IL, State of MO, State of MS, California State University, Sacramento Area Sanitation Department, SMUD, Sound Transit, LA Superior Courts, District of Columbia, UMAS, University of Central Florida and Hennepin County and many more.
Job Description
Perform audits of evidentiary documentation provided by claimants such as invoices, sales journals, general ledgers, bank statements and inventory entries to determine compliance with tax laws and regulations. Assess and explain requirements to claimants. Information gathering through investigative interviews and documentation acquisition.
Qualifications
Attention to detail to ensure compliance with all applicable laws, rules, regulations and policies, as well as to ensure quality of work submitted Technical skills to interpret laws, rules, regulations and policies. Application of GAAP principals in the analysis of taxpayer records. Verbal communication skills to communicate effectively and reliably. Computer skills to create, manipulate and enhance digital files and information within a variety of standardized computer operating systems.
Additional Information
All your information will be kept confidential according to EEO guidelines.
Compliance Auditor IPPS/OPPS
Auditor Job In Radnor, PA
Could you be our next Compliance Auditor IPPS/OPPS with Main Line Health? Make an Impact! Compliance Auditor Inpatient Perspective Payment System/Outpatient Perspective Payment System (IPPS/OPPS) reviews inpatient hospital claims for proper reimbursement and handles provider disputes in a result-oriented and metrics-driven environment. The Inpatient Compliance Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment and appropriate diagnosis related group (DRG) assignments. Analyzes, enters, and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods in conjunction with Audit Manager and requires minimal direction and receives guidance where needed.
In accordance with current federal & state coding compliance regulations and guidelines, the Compliance Auditor IPPS/OPPS performs 2nd level reviews of previously coded inpatient accounts for MS-DRG validation purposes-including the accuracy and completeness of all ICD-10-CM and ICD-10-PCS code assigned by inpatient coders. Ensure appropriate MS-DRG & APR-DRG, including SOI & ROM scores. Performs 2nd level reviews of variables affecting MS-DRG and/or APR-DRG-such as-HACs, PSIs, Elixhauser Comorbidities, etc.
Develop and Grow your Career! Invest in furthering your education through seeking certifications or advanced degrees by taking advantage of our Tuition Reimbursement! This position is eligible for up to $6,000 per year based upon your Full or Part Time status.
Join the Team! Like our patients, the Main Line Health Family encompasses a wide range of backgrounds and abilities. Just as each of our patients requires a personalized care plan, each of our employees, physicians, and volunteers, bring distinctive talents to Main Line Health. Regardless of our unique design, we all share a purpose: providing superior service and care.
Position-Specific Benefits: You are eligible for up to 200 hours of paid time off per year. We also offer a number of employee discounts to various activities, services, and vendors... And employee parking is always free!
Position: Compliance Auditor IPPS/OPPS
Shift: Day Shift, Monday - Friday
Experience:
* Minimum of 5 years' experience performing inpatient coding reviews and audits required.
* Must possess and maintain one of the following active certifications for at least four years:
Certified Coding Specialist (CCS)
Registered Health Information Technician (RHIT)
Registered Health Information Administrator (RHIA)
Certified Inpatient Coder (CIC)
* At least 5 years of work experience in MS-DRG and APR-DRG coding/auditing required.
* Minimum of 3 years' experience in ICD-10-CM/PCS coding and auditing within a Level 1 Trauma hospital required.
Education:
Associate's degree in business/health administration with two years of experience within a coding environment or a Bachelor's degree in Healthcare Administration is required.
Formal ICD-10-CM, ICD-10-PCS, CPT-4 training required.
Additional Information
* Requisition ID: 75030
* Employee Status: Regular
* Benefit Eligibility: Full-Time Benefits
* Schedule: Full-time
* Shift: Day Job
* Pay Range: $70,012.80 - $108,492.80
* Job Grade: 112
Multiple positions for Auditor(GAAP Exp) $13.25/hr
Auditor Job In Wilmington, DE
360 IT Professionals is a Software Development Company based in Fremont, California that offers complete technology services in Mobile development, Web development, Cloud computing and IT staffing. Merging Information Technology skills in all its services and operations, the company caters to its globally positioned clients by providing dynamic feasible IT solutions. 360 IT Professionals work along with its clients to deliver high-performance results, based exclusively on the one of a kind requirement.
Qualifications
·
Perform audits of evidentiary documentation provided by claimants such as invoices, sales journals, general ledgers, bank statements and inventory entries to determine compliance with tax laws and regulations. Assess and explain requirements to claimants.
·
Attention to detail to ensure compliance with all applicable laws, rules, regulations and policies, as well as to ensure quality of work submitted.
·
Application of GAAP principals in the analysis of taxpayer records.
·
Computer skills to create, manipulate and enhance digital files and information within a variety of standardized computer operating systems.
·
Customer relations and customer service, internal and external to the agency.
Additional Information
In person interview is acceptable
Audit Staff - Public
Auditor Job In Dover, DE
We are offering an exciting opportunity in the financial industry, located in Dover, Delaware, United States. We are looking for an Audit Staff - Public to join our team, who will play a crucial role in performing audit functions, working with accounting software systems, and handling audit engagements.
Responsibilities:
- Conducting regular audits, including financial, operational, and information systems audits, to ensure compliance with regulations and standards
- Preparing and executing audit plans and programs, ensuring all audit activities are performed accurately and efficiently
- Utilizing various accounting software systems, such as CaseWare, CCH ProSystem Fx, and CCH Sales Tax, for auditing purposes
- Participating in annual internal and external audits, contributing to the development of audit processes and procedures
- Assisting in audit engagements, actively communicating with clients to gather necessary information and address their inquiries
- Implementing and monitoring budget processes, ensuring the effective allocation of resources during audit engagements
- Maintaining up-to-date knowledge of auditing practices and industry regulations, applying this knowledge to improve audit functions
- Reviewing and verifying the accuracy of financial records and reports, identifying discrepancies and suggesting corrective actions
- Collaborating with the team to achieve audit objectives and improve overall audit efficiency
Requirements
- Possess a minimum of 2 years of experience in public auditing.
- Demonstrated proficiency in Accounting Software Systems.
- Familiarity with Audit Program is required.
- Experience with CaseWare is advantageous.
- Proficiency in CCH ProSystem Fx and CCH Sales Tax is expected.
- Experience in handling Audit Engagements is essential.
- Proficiency in Auditing is required.
- Must have the ability to create and manage Audit Plans.
- Familiarity with Budget Processes is expected.
- Prior experience in Audit - Financial, Annual Internal Audit, and Annual External Audit is advantageous.
- Proficiency in Audit - Information Systems and Audit - Operational is expected.
- Must be capable of handling Audit Activities and ensuring Audit Compliance.
For more information on this Audit Staff - Public role and other full time accounting and finance opportunities, please contact us at 302.985.5215 and reference JO#00800-0013081823.
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) .
Auditor
Auditor Job In Wilmington, DE
JOB RESPONSIBILITIES
Audits activities of various departments for compliance with plans, policies, and procedures as prescribed by management.
Prepares and submits reports on the results of work performed.
Cooperates with outside auditors in any undertaking which may expedite their work.
Submits a finished product consistent with the requirements of the department relative to work standards and due professional care.
Manages time and assignments to meet established deadlines.
Daily reviews of work and audit program to ensure professional standards and the objectives of the audit are met.
Promotes outstanding customer relations.
Promotes honesty and trust amongst the team.
Performs all other duties as assigned.
JOB REQUIREMENTS
No prior experience is required.
Must be able to successfully complete the background check and licensing process, required by the Delaware Lottery during employment.
Bachelor's Degree preferred
Proficiency in Microsoft Office products.
Excellent verbal and written communication skills are required.
A valid driver's license is required.
Must be able to lift twenty (20) lbs. repeatedly without difficulty.
Must be able to stand, sit, and walk for extended periods.
Must be able to work a flexible schedule based on the business needs.
Senior Auditor - Technology
Auditor Job In West Chester, PA
As part of the application process, a candidate account is required to log in and view application(s). Please be sure to check email regularly for information regarding our employment process.
Seeking a highly skilled Technology Sr. Auditor with expertise responsible for directing the daily progress of assigned Technology audits in Resolution Life and providing guidance to the assigned Auditors. The candidate will be responsible for evaluating technology related risk and controls, designing audit procedures to ensure controls are effective and in compliance with relevant regulations. This role requires understanding of IT auditing principles and practices.
Position Description:
Technical
Perform the planning for audits by:
Preparing process flows/narratives of processes within the areas being audited to ensure proper identification of risks, assessment of key technology controls, and the development of appropriate testing strategies
Identifying opportunities to enhance the audit process by utilizing Computer Assisted Auditing Tools (CAATs)
Ensure accurate and complete testing of technology key controls is performed in accordance with established standards and protocols through:
Reviewing the audit program, assignment of staff to audits, and testing performed.
Ensuring that CAATs reports are developed and utilized, where applicable
Reviewing potential technology audit issues and approving conclusions
Reviewing and/or preparing draft audit reports, depending on complexity of the audit
Perform continuous monitoring and business surveillance activities as well as assist with special projects as assigned by the Audit Manager or Audit Functional Leader
Client
Develop relationships with clients within the technology area.
Respond timely to requests from management on critical questions and issues.
Where applicable, provide consultation to assist the client with implementation of new systems and processes, and the related new/improved controls.
Monitor the client's progress/resolution efforts of high-risk issues in the technology area and follow up with management to ensure that unresolved control matters are being addressed.
Discuss audit recommendations and reports with management.
Demonstrates ability to lead an audit or workstream.
Proactively identifies risks and issues as they arise.
Overall
Lead the fieldwork of technology audits to ensure that accurate and complete testing of key controls is performed in compliance with established protocols and auditing standards.
Create and lead change by identifying pragmatic improvement opportunities.
Lead with passion and clarity by effectively supervising and supporting Audit staff, leading, and collaborating with peers to achieve team objectives.
Gain exposure to the Chief Audit Executive and the Executive Leadership Team.
Skills / Knowledge / Abilities:
6+ years of experience in technology auditing, including experience supervising audits is preferred.
Experience and knowledge of financial services/insurance industry.
Bachelor's degree with emphasis in IT, Accounting, Finance, or Business, is required.
Advanced degree (MBA) and/or professional certification (CIA, CISA, CISSP, etc.) is preferred.
Ability to manage groups of professionals to accomplish team objectives.
Builds effective and collaborative peer-level relationships.
Demonstrates strong analytical and critical thinking skills.
Proactively identifies and resolves issues as they arise.
Strong written and verbal communication skills
Demonstrates continuous learning and sharing of best practices within the team.
Ability to work independently and effectively to contribute to team objectives.
Good knowledge of IT regulations and standard such as COBIT, ISO 27001, internal controls, and IIA standards
Good knowledge and understanding of Accounting/Financial Risk, IT Risk, and Compliance Risk
Proficiency in use of audit software (ServiceNow) is a plus.
Experience with data analytics and audit automation tool is a plus.
Location: West Chester, PA preferred (generally 1-2 days/week in the office, may be more); Open to Atlanta, GA
Resolution Life US is committed to disclosing a reasonable estimate of the base salary for our job roles. These estimates consider a wide range of factors in making base salary decisions, including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs.
In addition to salary, Resolution Life US offers a comprehensive benefits package, including our health & wellness program, incentive and recognition programs, and 401k contribution (
all benefits are subject to eligibility requirements
). The salary range reflects figures based on the primary location, which is listed first. The range for the role may differ based on the location.
West Chester, PA - $92,000 - $110,000
Atlanta, GA: $83,000 - $100,000
Critical Skills
At Resolution Life, we have identified the following critical skills which are key to success in our culture:
Customer Focused: Passionate drive to delight our customers and offer unique solutions that deliver on their expectations.
Critical Thinking: Thoughtful process of analyzing data and problem solving data to reach a well-reasoned solution.
Team Mentality: Partnering effectively to drive our culture and execute on our common goals.
Business Acumen: Appreciation and understanding of the financial services industry in order to make sound business decisions.
Learning Agility: Openness to new ways of thinking and acquiring new skills to retain a competitive advantage.
Internal Auditor III
Auditor Job In Bryn Mawr, PA
Essential Utilities, Inc. delivers safe, clean, reliable services that improve quality of life for individuals, families, and entire communities.
Operating as the Aqua (water and wastewater services) and the Peoples and Delta (natural gas) brands, Essential serves approximately 5.5 million people across 10 states. We are committed to sustainable growth, operational excellence, a superior customer experience, and premier employer status - including a competitive and comprehensive benefits package as well as a commitment to career growth opportunities.
We are advocates for the communities we serve and are dedicated stewards of natural lands, protecting more than 7,600 acres of forests and other habitats throughout our footprint.
Our company is one of the most significant publicly traded water, wastewater service and natural gas providers in the U.S.
Are you looking for a fantastic career at Essential? We have a great opportunity for an Internal Auditor III, under the direction of the Manager, Internal Audit. The Internal Auditor III will be a key team member in the performance of our risk-based operational auditing program driving value for our Company.
Executes audits in accordance with our annual operational audit plan. Determines the effectiveness and efficiency of processes and controls which results in proposed improvements. Assures that major risks are adequately controlled, and assets are safeguarded. Evaluates compliance to policies, plans, procedures, laws, and regulations.
Prepares clear, accurate, and well-organized audit documentation that appropriately evidences the work performed.
Develops the audit report including impactful audit opportunities and improvements.
Manages the operational audit opportunities follow-up process, which requires communication with the owners of the management action plans and evaluation of actions they took to address the identified risks.
Will help to build our data analytics capabilities.
Assists in Sarbanes-Oxley (SOX) testing of financial and IT controls.
Aids in fraud related investigations. Gathers data and prepares and reviews findings with management.
Assists with other tasks or projects as assigned.
Qualifications
Bachelor's degree in Accounting, Finance, or a related field
CPA, CIA, or other certification is helpful
A minimum of four years of audit experience. Experience working with SAP and data analytics tools is a plus.
Knowledge, Skills, and Abilities:
Excellent written and verbal communications skills; communicate effectively (clearly, concisely, and professionally) with internal customers
Strong data analytics and spreadsheet skills
Ability to work collaboratively with others
Strong customer service skills
Must have ability to plan for and work under deadline
Ability to work on multiple projects simultaneously and adapt to changing priorities in a fast-paced environment
A team player able to work effectively in a team fostered multi-tasking environment
Working Conditions/Physical Demands
Perform sedentary work- exerting up to 20 pounds of force occasionally, and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time.
Working conditions include travel to work sites of Essential Utilities and/or other constituents (if applicable)
Travel Requirements up to 15%
Essential Utilities, Inc., is an Equal Opportunity/Affirmative Action employer. Equal employment opportunity is provided to all employees and applicants for employment without regard to the following legally protected characteristics: race, color, religion, sex, national origin, age, pregnancy (including childbirth and related medical conditions, including medical conditions related to lactation), physical or mental disability, covered-veteran status, genetic information (including testing and characteristics), sexual orientation, gender identity or expression or any other characteristic protected by applicable local, state or federal law.
Essential Utilities is committed to providing reasonable accommodation to individuals with disabilities. If you have a condition that may prevent you from applying for a job online or need to request an accommodation during the interview process, please call (***************.
To maintain the integrity of the recruitment process and to avoid real or perceived conflicts of interest due to employment and/or assignment of family members and personal referrals, specific guidelines apply to the hiring and assignment of these individuals including, but not limited to:
Family members cannot result in a supervisor/subordinate reporting relationship
Family members cannot work in the same department.
Internal Auditor III
Auditor Job In Bryn Mawr, PA
Essential Utilities, Inc. delivers safe, clean, reliable services that improve quality of life for individuals, families, and entire communities. Operating as the Aqua (water and wastewater services) and the Peoples and Delta (natural gas) brands, Essential serves approximately 5.5 million people across 10 states. We are committed to sustainable growth, operational excellence, a superior customer experience, and premier employer status - including a competitive and comprehensive benefits package as well as a commitment to career growth opportunities.
We are advocates for the communities we serve and are dedicated stewards of natural lands, protecting more than 7,600 acres of forests and other habitats throughout our footprint.
Our company is one of the most significant publicly traded water, wastewater service and natural gas providers in the U.S.
Are you looking for a fantastic career at Essential? We have a great opportunity for an Internal Auditor III, under the direction of the Manager, Internal Audit. The Internal Auditor III will be a key team member in the performance of our risk-based operational auditing program driving value for our Company.
* Executes audits in accordance with our annual operational audit plan. Determines the effectiveness and efficiency of processes and controls which results in proposed improvements. Assures that major risks are adequately controlled, and assets are safeguarded. Evaluates compliance to policies, plans, procedures, laws, and regulations.
* Prepares clear, accurate, and well-organized audit documentation that appropriately evidences the work performed.
* Develops the audit report including impactful audit opportunities and improvements.
* Manages the operational audit opportunities follow-up process, which requires communication with the owners of the management action plans and evaluation of actions they took to address the identified risks.
* Will help to build our data analytics capabilities.
* Assists in Sarbanes-Oxley (SOX) testing of financial and IT controls.
* Aids in fraud related investigations. Gathers data and prepares and reviews findings with management.
* Assists with other tasks or projects as assigned.
Qualifications
* Bachelor's degree in Accounting, Finance, or a related field
* CPA, CIA, or other certification is helpful
* A minimum of four years of audit experience. Experience working with SAP and data analytics tools is a plus.
Knowledge, Skills, and Abilities:
* Excellent written and verbal communications skills; communicate effectively (clearly, concisely, and professionally) with internal customers
* Strong data analytics and spreadsheet skills
* Ability to work collaboratively with others
* Strong customer service skills
* Must have ability to plan for and work under deadline
* Ability to work on multiple projects simultaneously and adapt to changing priorities in a fast-paced environment
* A team player able to work effectively in a team fostered multi-tasking environment
Working Conditions/Physical Demands
* Perform sedentary work- exerting up to 20 pounds of force occasionally, and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time.
* Working conditions include travel to work sites of Essential Utilities and/or other constituents (if applicable)
* Travel Requirements up to 15%
Essential Utilities, Inc., is an Equal Opportunity/Affirmative Action employer. Equal employment opportunity is provided to all employees and applicants for employment without regard to the following legally protected characteristics: race, color, religion, sex, national origin, age, pregnancy (including childbirth and related medical conditions, including medical conditions related to lactation), physical or mental disability, covered-veteran status, genetic information (including testing and characteristics), sexual orientation, gender identity or expression or any other characteristic protected by applicable local, state or federal law.
Essential Utilities is committed to providing reasonable accommodation to individuals with disabilities. If you have a condition that may prevent you from applying for a job online or need to request an accommodation during the interview process, please call (***************.
To maintain the integrity of the recruitment process and to avoid real or perceived conflicts of interest due to employment and/or assignment of family members and personal referrals, specific guidelines apply to the hiring and assignment of these individuals including, but not limited to:
* Family members cannot result in a supervisor/subordinate reporting relationship
* Family members cannot work in the same department.
DoD Financial Systems Auditor - SAP Experience
Auditor Job In Aberdeen, MD
Aalis Management Consulting is an 8(a) certified Service-Disabled Veteran-Owned Small Business (SDVOSB) and Economically Disadvantaged Woman-Owned Small Business (EDWOSB) driven by the same principles that guide our armed forces. Founded by a US Army veteran, we take pride in our core values: excellence in reputation, commitment, candor, teamwork, and dependability. Our team delivers stakeholder-focused support in the areas of Acquisition & Procurement Support, (IT) Financial Management, Program Management, and Logistics & Supply Chain Support. Visit us at ***************
Title: Government Financial Auditor - SAP Experience
Client: Federal Agency
Location: Aberdeen Proving Ground, MD (Onsite)
Clearance: Secret
Security Clearance Statement: This position requires a government security clearance; the applicant must be a U.S. Citizen for consideration.
Number of Position(s): 1
Work Schedule: 8:00 am - 5:00
Work Day: Monday - Friday
Job DescriptionAalis Management Consulting is seeking a Government Financial Auditor with expertise in DoD financial management and audit readiness to support critical compliance initiatives at Aberdeen Proving Ground (APG). The ideal candidate will have 4+ years of federal financial auditing experience, deep knowledge of GAAP, FASAB, and DoD regulations, and certifications such as CPA, CISA, or CDFM.
Key Responsibilities
Conduct audit readiness assessments for DoD financial statements, ensuring compliance with GAAP, FASAB, and GAGAS.
Evaluate internal controls over financial reporting (ICOFR) per OMB Circular A-123 and GAO Green Book.
Identify and remediate financial statement risks, deficiencies, and material weaknesses.
Support DoD Financial Management Regulation (FMR) compliance and Risk Management Framework (RMF) integration.
Review DoD systems (e.g., GFEBS, LMP) for alignment with federal financial policies.
Prepare audit documentation, briefings, and corrective action plans for DoD leadership.
Advise on personnel, acquisition, property, and inventory management policies.
Required Qualifications
Must have a Bachelor's Degree (B.A./B.S.) in Accounting, Finance, or Business.
Must have 4+ years of DoD financial management/audit experience, including:
Audit readiness (e.g., Statement of Budgetary Resources, Balance Sheet).
OMB A-123, FMR, and FASAB standards.
DoD systems (e.g., GFEBS, DAI, PBUSE).
DoD 8570.01-M or DoD 8140 Certification: IAM Level II or IAT Level III (e.g., CAP, CISSP, CISM).
Familiarity with RMF, DoD property management, and federal financial systems.
Preferred Qualifications
Certifications: CPA, CISA, PMP, CGFM, or CDFM.
Experience with DoD FISCAM controls testing or Sarbanes-Oxley (SOX) compliance.
Knowledge of SAP ERP modules (FI/CO, FM) in DoD environments.
Keywords: SAP ERP modules, DoD FISCAM, Sarbanes-Oxley (SOX) compliance, OMB A-123, GAAP, FASAB
Aalis Management Consulting is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.
Audit Staff
Auditor Job In Bel Air, MD
- Assesses financial risk and standards across a company in regards to their employees.
- Collect and analyze financial data, perform interviews and assessments of employees, and apply accounting strategies to improve efficiency at the company.
- Obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor's report that includes the auditor's opinion.
Requirements:
- Bachelor's degree in Accounting, Finance, Economics, or another related field.
- 4-6 years of experience in external or internal auditing preferably within the banking sector.
- Maintain relevant certifications such as CIA, CPA, CISA, etc.
- Team player.
- Excellent communication skills (verbal and written)
DRG Coding Auditor
Auditor Job In Wilmington, DE
will work virtually._ _Alternate locations may be considered._ The **DRG CODING AUDITOR** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and its clients. Also responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding and DRG assignment accuracy. Specializes in review of DRG coding via medical record and attending physician's statement sent in by acute care hospitals on submitted DRG.
**How you will make an impact:**
+ Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines and objectivity in the performance of medical audit activities.
+ Draws on advanced ICD-10 coding expertise, clinical guidelines, and industry knowledge to substantiate conclusions.
+ Utilizes audit tools and auditing workflow systems and reference information to make audit determinations and generate audit findings letters.
+ Maintains accuracy and quality standards as set by audit management for the auditing concept, valid claim identification, and documentation purposes (e.g., letter writing).
+ Identifies new claim types by identifying potential claims outside of the concept where additional recoveries may be available, such as re-admissions, Inpatient to Outpatient, and HACs.
+ Suggests and develops high quality, high value concept and or process improvement and efficiency recommendations.
**Minimum Requirements:**
+ Requires at least one of the following: AA/AS or minimum of 5 years of experience in claims auditing, quality assurance, or recovery auditing.
+ Requires at least one of the following certifications: RHIA certification as a Registered Health Information Administrator and/or RHIT certification as a Registered Health Information Technician and/or CCS as a Certified Coding Specialist and/or CIC as a Certified Inpatient Coder.
+ Requires 5 years of experience working with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG.
**Preferred Skills, Capabilities and Experiences** :
+ BA/BS preferred.
+ Experience with vendor based DRG Coding / Clinical Validation Audit setting or hospital coding or quality assurance environment preferred.
+ Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies, billing validation criteria and coding terminology preferred.
+ Knowledge of Plan policies and procedures in all facets of benefit programs management with heavy emphasis in negotiation preferred
For candidates working in person or remotely in the below location(s), the salary* range for this specific position is $95,172 to $149,556.
Locations: Colorado; Illinois; Maryland; Minnesota; Nevada
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. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
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 II (US)
Auditor Job In Wilmington, DE
Audit & Reimbursement II 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 II 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 II will gain experience on the Medicare cost report and Medicare Part A Reimbursement. They will receive training to participate in contractual workload, along with opportunities to participate on special projects. This position provides a valuable opportunity to gain 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:
* Analyze and interprets data and makes recommendations for change based on their judgment and experience.
* 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.
* Perform cost report desk reviews.
* Assist on cost report audits, may serve as an in-charge auditor on less complex audits Dependent upon experience, may perform supervisory review on 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 in Finance/Accounting/Business.
* 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 remotely in the below locations, the salary* range for this specific position is $53,580 to $88,830
Locations: Nevada, Minnesota, Maryland, 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. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
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.
Auditor
Auditor Job In Wilmington, DE
This is Sushil Singh from 360 IT Professionals Inc. We are based in Fremont, California that offers complete technology services in IT staffing, Mobile development, Web development and Cloud computing . 360 IT Professionals work along with its clients to deliver high-performance results, based exclusively on the one of a kind requirement.
Job Description
Essential functions of the position include:
Perform audits of evidentiary documentation provided by claimants such as invoices, sales journals, general ledgers, bank statements and inventory entries to determine compliance with tax laws and regulations. Assess and explain requirements to claimants.
Information gathering through investigative interviews and documentation acquisition.
Attention to detail to ensure compliance with all applicable laws, rules, regulations and policies, as well as to ensure quality of work submitted.
Technical skills to interpret laws, rules, regulations and policies.
Application of GAAP principals in the analysis of taxpayer records.
Verbal communication skills to communicate effectively and reliably.
Computer skills to create, manipulate and enhance digital files and information within a variety of standardized computer operating systems.
Readiness and willingness to learn new computer programs and corresponding enhancements to existing programs already in use.
Customer relations and customer service, internal and external to the agency.
Additional Information
If interested, Kindly share your resume to sushil@360itpro,com or call me on 510-254-3300 Ext. 138
Internal Auditor
Auditor Job In Wilmington, DE
Thriving financial services organization is looking to staff an Internal Auditor who can evaluate the effectiveness of internal controls, risk management processes, and governance practices with the organization. This role conducts independent assessments to ensure compliance with regulatory requirements in addition to the following: assisting with control testing, preparing audit documentation, reviewing financial data and analytics, assisting with risk management, developing internal auditing plans, and identifying areas of improvement and recommending corrective action. The ideal Internal Auditor for this role must have the ability to drive performance, build strong relationships, and provide insight on internal controls and financial accuracy.
Responsibilities
· Conduct risk assessments
· Ensure governance and compliance are controlled and met
· Performing full audits
· Control Management
· Analyze and evaluate accounting documents
· Develop processes and plans to increase revenue
Requirements
The ideal Internal Auditor will have a Bachelors degree in Accounting/Finance/Economics.
Other requirements for the Internal Auditor role include and are not limited to:
· 3+ years internal or external audit experience
· CPA preferred
· Advanced Microsoft Office skills
· Excellent analytical skills
· Light travel required
For more information on this Internal Auditor role and other full-time accounting and finance opportunities, please contact us at 302.985.5183 and reference JO#00800-0012921078.
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) .