Auditor (Remote)
$49.1k - $97.53kCareFirst BlueCross BlueShield
Resp & Qualifications Purpose Assess the organization's operational, financial, regulatory and compliance controls to ensure processes function efficiently and remain in compliance with CareFirst policies, procedures and regulations. Evaluates internal control processes to identify potential control deficiencies. Report audit findings to the supervisor or manager and recommend solutions to improve overall processes and control governance. Essential Functions Perform a variety of internal audit projects including operational, financial, regulatory and compliance, consulting projects, special reviews and management requests. Analyze and evaluate operations and strategies to identify opportunities for improvement in processes. Participate in the development of the risk assessment for the business process or project under review. Perform process walkthroughs and participate in the Entrance and Exit meetings. Assist in drafting audit findings, management action plans and draft report for management review. Maintain audit documentation in automated workpaper repository of business processes and related risks. Support with follow-up activities to validate completion of action plans. Support project monitoring initiatives by tracking audit and project milestones, identifying emerging risks, and coordinating with stakeholders to ensure timely completion of audit activities and related deliverables. Perform Model Audit Rule (MAR) activities, including testing and evaluating internal controls in accordance with regulatory requirements, documenting results, supporting issue identification and remediation tracking, and reporting MAR-related results and trends to audit leadership. Assist in monitoring the progress of operational, financial, regulatory and compliance audits as assigned, including participation in project monitoring activities to track project timelines, dependencies, risks and issue resolution. Contribute to the development of efficient and effective audit objectives, programs and testing procedures. Document walk-throughs of business processes utilizing flowcharting application (e.g., VISIO). Advise and consult on risk management and controls for new processes associated with the assigned projects, as appropriate, and demonstrate willingness to learn and apply IT General Controls (ITGCs) in support of technology-enabled processes. Follow-up with business owner/management to resolve identified issues, including internal control testing. Maintain a repository of operational, financial, regulatory and compliance audit issues and related corrective action plans. Monitor and provide periodic updates to the Senior and Lead auditors on the status of outstanding management action plans. May assist with monitoring remediation efforts related to technology and IT-enabled controls as experience and training are obtained. Assist in the coordination of external vendor audit, as well as operational, financial, regulatory and compliances audits as assigned. Qualifications Education Level: Bachelor’s Degree in Business Administration, Management Sciences, Finance, Accounting or related field OR in lieu of a Bachelor’s degree, an additional 4 years of relevant work experience is required in addition to the required work experience. Licenses/Certifications Preferred: Certified Internal Auditor (CIA) Certified Public Accountant (CPA) Certified Fraud Examiner (CFE) Experience: 1 year Experience in accounting, finance, auditing, insurance or relevant work experience in an operational capacity in the health care industry. Preferred Qualifications: Preferred that individual possess or is in the process of obtaining a professional certification in one of the following CPA, CIA, CFE, or other relevant professional certifications. Knowledge, Skills and Abilities (KSAs) Some knowledge of operational processes, state and federal regulatory and compliance guidelines, accounting principles and practices, with data analytic tools (e.g., Excel). Knowledge of various auditing methods, practices, standards (e.g., IIA). Recognize, analyze, and provide possible solutions for a variety of problems. The ability to communicate effectively both oral and written. Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging. Salary Range $49,104 - $97,526 Travel Requirements 5% Travel to various CareFirst offices, vendor locations, and training facilities. Salary Range Disclaimer The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements). Department Audit and Advisory Services Equal Employment Opportunity CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information. Federal Discretion/Physical Demand Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs. Physical Demands The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted. Sponsorship in US Must be eligible to work in the U.S. without Sponsorship #J-18808-Ljbffr
- ...BSI is seeking an Auditor for Environment, Health and Safety (EHS) to join our team. This home-based position requires extensive travel for on-site audits across Ohio, Michigan, and North Carolina. You will manage client portfolios and ensure compliance with ISO standards...Remote workWork from homeFlexible hours
- ...Growing regional public accounting firm is looking to hire a Senior Auditor with a strong audit background, a desire to learn and grow with... ...a total of 2 Saturdays over the course of the entire year. Remote flexibility. There will be requirements to travel to client...Remote workImmediate startWork from home1 day per week
$90k - $110k
...DRG Revenue Integrity Auditor Remote CareNational is looking for an experienced DRG Revenue Integrity Auditor ! Ideal candidates will have at least 5 years of recent experience. Pay Details: ~ Pay Range: $90,000 - 110,000 Work Setting: Remote...Remote workImmediate startWork from home$30.49 - $46.03 per hour
...Job Summary and Responsibilities As a Coding Auditor, you will be a central figure ensuring accurate and timely reimbursement by proactively... ...to maximizing financial accuracy and efficiency. As a remote employee, we will provide you with the equipment needed to work...Remote workWork at officeWork from home- ...A remote insurance firm is seeking Premium Auditors to leverage extensive insurance experience in a long-term work-at-home position. Candidates must have significant experience in premium auditing within Property & Casualty insurance. This role offers flexible scheduling...Remote workWork at officeWork from homeFlexible hours
- ...ARMStrong Insurance Services is hiring a Premium Auditor to join its team. This role involves conducting audits for various insurance policies and ensuring compliance with regulations, primarily working from home with travel to client locations. The ideal candidate will...Remote workWork from homeFlexible hours
- A leading global assurance provider is seeking a Food Safety and Quality Auditor to perform assessments and build client relationships. This home-based role requires extensive travel and GFSI Lead auditor certification. Candidates should have at least 3 years of experience...Remote workWork from home
$75k
...Brown & Joseph, LLC is looking for a Premium Auditor to join their team. The role involves conducting audits for businesses insured by commercial property and casualty insurers, which includes reviewing financial records for compliance and fraud detection. This position...Remote workWork from homeFlexible hours- A leading healthcare organization is seeking an Inpatient Medical Coding Auditor to work primarily from home. In this role, you'll be responsible for reviewing and coding inpatient hospital claims, ensuring accuracy for reimbursement. The ideal candidate will have a strong...Remote workWork from home
- ...A leading healthcare staffing company is seeking a Medical Coding Auditor in Houston, TX. This role involves reviewing surgical cases to verify the accuracy of coding and providing educational support to coders. Ideal candidates will have 2-5+ years of cardiology coding...Remote work
$100k
...insured and communicate the results to the home office Travel to multiple audit locations Hybrid position - work from home and complete remote audits 2-3 days per week Requirements Associate’s Degree or equivalent plus two years’ performing premium audits or equivalent...Remote workWork from homeHome office2 days per week3 days per week- A leading healthcare organization in Boston is seeking a detailed-oriented professional to conduct inpatient DRG reviews. The role requires an RN or LVN and an inpatient coding certification within 4-6 months of hire. Responsibilities include performing comprehensive DRG...Remote work
- A leading healthcare company is seeking an experienced Inpatient Medical Coding Auditor to join their remote workforce. The role involves reviewing inpatient hospital claims and ensuring correct payments while operating in a metrics-driven environment. Candidates should...Remote work
- ...CorroHealth Inc, based in Wisconsin, is seeking a DRG Revenue Integrity Auditor to perform audits on inpatient charts. This remote position will ensure compliance with federal laws and coding accuracy while providing training to new hires. The ideal candidate should have...Remote work
- ...Working from home in a full-time capacity, the Inpatient Coding Auditor will perform internal quality assessment reviews on coders to ensure compliance with coding guidelines, improve data integrity, and enhance the quality of physician documentation. Key responsibilities...Remote workFull timeWork from home
- ...A leading healthcare data platform is seeking an Inpatient Auditing Specialist. This position offers remote work flexibility and requires extensive coding and auditing experience. Responsibilities include conducting inpatient coding audits, providing coder education,...Remote workRelocation package
- A leading health services company is seeking an Inpatient Medical Coding Auditor to review hospital claims. This remote position requires expertise in medical coding, specifically MS-DRG. The ideal candidate will hold a relevant certification with at least four years of...Remote workFlexible hours
- ...Overview JOB TITLE: Auditor AGENCY SUPPORTED: U.S. Department of Justice (DOJ) – MEGA 6 Automated Litigation Support POSITION TYPE: Full‑Time, Contingent Upon Award LOCATION: Remote CLEARANCE: Public Trust – Candidates do not need to be cleared at the time of application...Remote workFull timeContract workInterim roleWork from homeHome officeFlexible hours
- ...CGS Administrators LLC is seeking a full-time Auditor for a remote position that allows working from any U.S. location. The role includes conducting operational and compliance audits, preparing detailed reports, and ensuring internal control effectiveness. Ideal candidates...Remote workFull timeFlexible hours
- Job Announcement As needed, additional positions may be filled using this announcement. This position is also being announced to applicants eligible to apply through Merit Staffing procedures under 26-NYW-12986888-MS.Remote work
- ...Xtend Healthcare is seeking a DRG Revenue Integrity Auditor to perform DRG validation and chart reviews for inpatient records. You will... ...accurate classifications and compliant documentation. This remote role offers a salaried schedule, opportunities for professional...Remote work
- A leading health services provider is seeking an experienced Inpatient Medical Coding Auditor to work remotely. This position involves reviewing hospital claims for accuracy and ensuring correct coding practices are followed. Candidates must have RHIA, RHIT, or CCS certification...Remote workFlexible hours
- ...Overview JOB TITLE: Senior Auditor AGENCY SUPPORTED: U.S. Department of Justice (DOJ) – MEGA 6 Automated Litigation Support POSITION TYPE: Full-Time, Contingent Upon Award LOCATION: Remote CLEARANCE: Public Trust – Candidates do not need to be cleared at the time of application...Remote workFull timeContract workInterim roleWork from homeHome officeFlexible hours
- ...is seeking an Inpatient Auditing Specialist who will perform audits on medical records and ensure compliance with DRGs. This fully remote role requires 3+ years of coding and auditing experience and offers a flexible schedule. Responsibilities include conducting audits...Remote workFlexible hours
- AdventHealth in Tampa, Florida is seeking a dedicated coding specialist to perform quality reviews on coded records, ensuring accurate ICD-10 coding. The role also involves educating coders and collaborating with clinical staff. The ideal candidate has a strong coding ...Remote work
- ...collaboration platform is seeking an Inpatient Auditing Specialist to conduct coding audits and provide coder education. The role is fully remote, allowing for a flexible schedule while focusing on reviewing and validating DRGs for Medicare. Required qualifications include at...Remote workFull timeFlexible hours
- ...Inpatient Medical Coding Auditor – PPI Coding Disputes Reports to the manager and reviews DRG, ICD-10-CM, and PCS coding assignments... ...Career development opportunities. Work Arrangement Work from home, remote. Occasional travel to Humana offices for training or meetings...Remote workBi-weekly payWork at officeWork from homeHome officeMonday to Friday
$140k - $250k
...dedicated professional to ensure the integrity and compliance of our financial processes. This position offers the flexibility of remote work while allowing you to contribute significantly to our mission. Key Responsibilities ~Conduct thorough audits of financial...Remote workFull time$82.72k - $108.57k
...Oscar is hiring an Associate, Risk Adjustment Auditor to join our Risk Adjustment team. This role involves conducting quality audits... ...implement benchmarks and quality assurance programs. This is a remote position available to candidates from select states. The base pay...Remote work- ...CGS Administrators LLC is looking for an experienced Auditor for a full-time, remote position. This role requires conducting operational and compliance audits, drafting reports, and leading audit teams. Candidates should have at least 5 years of auditing experience, with...Remote workFull timeFlexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Auditor (Remote). Be the first to apply!
- sales auditor Baltimore, MD
- remote nurse auditor Baltimore, MD
- inventory auditor Baltimore, MD
- coding auditor Baltimore, MD
- medical records auditor Baltimore, MD
- remote auditor Baltimore, MD
- security auditor Baltimore, MD
- safety auditor Baltimore, MD
- field auditor Baltimore, MD
- medical claims auditor Baltimore, MD


