Medical Auditor

5 days ago


New Haven, United States Saint Francis Health System Full time

Full Time

Job Summary: The Compliance Nurse Auditor assists with and supports the compliance program activities within Saint Francis Health System (SFHS). This role supports clinical coding and billing audit functions as well as the performance of routine and complex audits, oversight activities, and coordinates remediation and corrective action plans.

Minimum Education: Has completed the basic professional curricula of a school of nursing as approved and verified by a state board of nursing, and holds or is entitled to hold a diploma or degree therefrom.

Work Experience: Minimum 3 years of healthcare compliance clinical auditing experience within a hospital setting.

Strong knowledge of Centers for Medicare and Medicaid Services (CMS) guidance, regulations, policies, and direction from other government programs. Advanced proficiency within Microsoft 365. Ability to learn departmental and job-specific software programs. Superior ability to collect, analyze, and disseminate significant amounts of data with attention to detail and accuracy. Strong project management skills with the ability to manage multiple priorities simultaneously.

Provides compliance program support with audits and monitoring, corrective action plan management, data analytics, and other projects to ensure proper execution of the compliance program work plan and priorities. Performs audits to ensure that the clinical documentation contained within the patient chart supports items and services included on claims and accurately supports reasons for treatment, billing, payment, and operations. Performs clinical review audits to validate compliance with regulatory requirements such as Emergency Medical Treatment Labor Act (EMTALA), Discharge Planning, and Quality. Provides independent evaluations and assists with the maintenance of operational controls, tools, policies, and procedures. Conducts regulatory research to identify gaps and provides interpretation of clinical requirements and regulations to ensure appropriate application of medical and clinical criteria. Remains abreast of current developments in compliance.

Decision Making: Independent judgment in planning sequence of operations and making minor decisions in a complex technical or professional field

Works with internal and/or external customers via telephone or face to face interaction. Works with other healthcare professionals and staff. Supplemental Information: This document generally describes the essential functions of the job, and the physical demands required to perform the job. Corporate Compliance - Yale Campus

EOE Protected Veterans/Disability


  • Medical Bill Auditor

    3 weeks ago


    New York, New York, United States Alaffia Health Full time

    We are seeking a skilled Medical Bill Auditor to help us modernize medical claim auditing. As a key member of our team, you will be responsible for reviewing and analyzing medical claims, patient medical records, and automatic claim audit results to help train our machines to deliver automated audit results.Your role will be integral to our engineering teams...


  • New Haven, United States Saint Francis Health System Full time

    Current Saint Francis Employees - Please click HERE to login and apply.Full Time8:00a - 4:30pJob Summary: The Compliance Nurse Auditor assists with and supports the compliance program activities within Saint Francis Health System (SFHS). This role supports clinical coding and billing audit functions as well as the performance of routine and complex audits,...


  • New Haven, United States Saint Francis Health System Full time

    Current Saint Francis Employees - Please click HERE to login and apply. Full Time 8:00a - 4:30p Job Summary: The Compliance Nurse Auditor assists with and supports the compliance program activities within Saint Francis Health System (SFHS). This role supports clinical coding and billing audit functions as well as the performance of routine and complex...


  • New Haven, United States Saint Francis Health System Full time

    Current Saint Francis Employees - Please click HERE to login and apply. Full Time 8:00a - 4:30p Job Summary: The Compliance Nurse Auditor assists with and supports the compliance program activities within Saint Francis Health System (SFHS). This role supports clinical coding and billing audit functions as well as the performance of routine and complex...


  • New York, New York, United States Happier People Management Full time

    Job Summary: We are seeking a highly skilled Medical Coding Auditor to join our team at Happier People Management. As a Medical Coding Auditor, you will be responsible for coordinating, attending, and auditing counts during physical inventories, as well as performing daily cycle counts of merchandise, date-code audits, asset cycle counts, and internal...

  • Medical Bill Auditor

    3 weeks ago


    New York, New York, United States Alaffia Health Full time

    About Alaffia Health & Our MissionAt Alaffia Health, we're tackling the $500B issue of medical billing fraud, waste, and administrative burden in the U.S. healthcare system. Our team of clinicians, AI/ML engineers, and product experts is building advanced AI to reduce healthcare costs. We're a high-growth, venture-backed startup based in NYC, actively...


  • New York, New York, United States Vibrant Emotional Health Full time

    Job Title: Internal Compliance AuditorVibrant Emotional Health is seeking a detail-oriented and analytical Internal Auditor to join our internal audit team. Reporting to the Director of Internal Audit, the Internal Auditor will be responsible for conducting independent and objective audits to evaluate the effectiveness of our internal controls, risk...


  • New York, United States Maimonides Medical Center Full time

    Coding & Billing AuditorTHE BEST CAREERS. RIGHT HERE@ BROOKLYN’S LEADING HEALTHCARE SYSTEM.MAIMONIDES: TOP TEN IN THE U.S. FOR CLINICAL OUTCOMESWe’re Maimonides Health, Brooklyn’s largest healthcare system, serving over 250,000 patients each year through the system’s 3 hospitals, 1800 physicians and healthcare professionals, more than 80...


  • New York, New York, United States Vibrant Emotional Health Full time

    Job Title: Internal Compliance AuditorJob Summary:We are seeking a detail-oriented and analytical Internal Auditor to join our internal audit team at Vibrant Emotional Health. As an Internal Compliance Auditor, you will be responsible for conducting independent and objective audits to evaluate the effectiveness of our internal controls, risk management, and...


  • New York, New York, United States Burns Recruitment Full time

    Auditor RoleBurns Recruitment is proud to partner with a reputable public accounting firm in a dynamic environment. This combined role for Audit Staff Accountants and Senior Auditors offers opportunities for both new graduates and experienced professionals to join a supportive and innovative firm.Key Responsibilities:Perform audits, reviews, and compilations...

  • Night Auditor

    4 weeks ago


    New Orleans, Louisiana, United States Hotel Theo Full time

    Job SummaryRaines Co. is seeking a Part-Time Night Auditor to join our team. As a Night Auditor, you will be responsible for processing night audit and running reports, while providing excellent service to our guests.We offer a competitive benefits package, including Medical/Dental/Vision benefits, a generous PTO program, points-based bonus, daily pay, and...


  • New York, New York, United States Vibrant Emotional Health Full time

    Job Title: Internal Compliance AuditorAt Vibrant Emotional Health, we are seeking a detail-oriented and analytical Internal Auditor to join our internal audit team. The successful candidate will be responsible for conducting independent and objective audits to evaluate the effectiveness of our internal controls, risk management, and governance processes.Key...


  • New Orleans, Louisiana, United States Hotel Theo Full time

    Part-Time Night Auditor Job DescriptionRaines Co. - Your Future is NowJob Summary: We are seeking a skilled Part-Time Night Auditor to join our team. As a Night Auditor, you will be responsible for processing night audit and running reports while providing exceptional service to our guests.Key Responsibilities:Process night audit and run reportsProvide...

  • Inventory Auditor

    4 weeks ago


    New York, New York, United States Happier People Management Full time

    Job OverviewHappier People Management is seeking a highly skilled Inventory Auditor to join our team. As an Inventory Auditor, you will be responsible for ensuring the accuracy and integrity of our inventory management system.Key ResponsibilitiesConduct physical inventories and audits to ensure accuracy and completeness of inventory records.Perform daily...


  • New York, New York, United States Vibrant Emotional Health Full time

    Job Title: Internal Compliance AuditorJob Summary:Vibrant Emotional Health is seeking a detail-oriented and analytical Internal Compliance Auditor to join our internal audit team. The successful candidate will be responsible for conducting independent and objective audits to evaluate the effectiveness of our internal controls, risk management, and governance...


  • New Haven, United States TEKsystems Careers Full time

    *This is an Accountant II Business Financial Coordinator role. This person needs a 4 year Bachelor's Degree in Finance and will be working hybrid with 2 days remote on a 6 month contract to hire with a 3 round interview process and a conversion salary range of **$57k-$90k**** * *Description:* Reporting to the Manager for IT Business Operations, this role is...


  • New Haven, United States TEKsystems Careers Full time

    *This is an Accountant II Business Financial Coordinator role. This person needs a 4 year Bachelor's Degree in Finance and will be working hybrid with 2 days remote on a 6 month contract to hire with a 3 round interview process and a conversion salary range of **$57k-$90k**** * *Description:* Reporting to the Manager for IT Business Operations, this role is...


  • New York, United States Holland America Group Full time

    SBN - Night Auditor ClerkDepartment: Guest Svc Employment Type: Fixed Term Contract Location: Global Reporting To: Chief Purser Description To provide guests with friendly, personalized service during the night shift, reconciliation of all onboard accounting. The Night Auditor plays an important part of the guest service team as they have direct contact...

  • Night Auditor

    4 weeks ago


    New York, New York, United States STAYPINEAPPLE Full time

    Impeccable Service Never SleepsAs a Night Auditor at Staypineapple, you will be responsible for maintaining our high standards of guest service overnight and ensuring the property is safe and secure.Your Key Responsibilities:Completing front desk duties, including check-ins/outs, room scheduling, and handling guest requests.Maintaining knowledge of current...

  • Night Auditor

    3 weeks ago


    New York, New York, United States VOCO the Franklin Hotel New York Full time

    Job Summary:The Night Auditor is responsible for the preparation and disposition of all Night Audit work. This role requires a high level of attention to detail and organizational skills to ensure accurate and efficient processing of financial transactions.Responsibilities:Register guests and make reservations in a timely and professional manner.Prepare and...