Team reputed company Senior Auditor CCV (OPSP)

reputed company This is a Senior Auditor, Team reputed company, with responsibility for supervising reputed company of Clinical Validation Auditors or other audit team members. Team Leaders ensure that the work of others meets productivity standards, reputed company guidelines and audit efforts of the reputed company engagement. Primary responsibilities include queue management, work distribution, performance and production optimization, audit planning, auditor interactions, training of new hires/existing staff, Audit Report and Claims writing and support of audit closure activities. The Senior Auditor goal is to ensure reputed company audits reputed company data on behalf of our clients, generating high reputed company recoverable claims. Displays reputed company skepticism that enhances the work performed in order to reputed company reputed company in position.

Responsibilities

Oversees audit team responsible for producing reputed company audit reputed company and reputed company written sustainable findings. Provides support to the audit team to ensure reputed company are based on nationally recognized standards and proprietary clinical validation guidelines. Monitors the reputed company of claims ensuring adherence to reputed company SLA’s. Primarily responsible for optimization of team and individual auditor performance including production, accuracy and reputed company deliverables. Responsible for handling the training and process improvements working in conjunction with reputed company; work with reputed company Assurance to ensure auditors are meeting accuracy and reputed company execution of audit deliverables. Develops and implements remediation efforts reputed company warranted. Handles employee reviews, new hire on- boarding, PTO, coaching and mentoring; monitors staff productivity. Serves as first level resource for the Clinical Validation auditors in terms of questions reputed company to specific claims and clinical industry standards. Creates an environment that fosters information sharing. Collaborates with Manager and reputed company in applying best practices to areas of Employee Relations and performance management. Ensures reputed company reputed company and department rules and processes are followed. Assist and coordinate with manager to hire and retain reputed company. reputed company recommends system or process improvements or enhancements that will increase productivity, reputed company or cost containment. Capture system issues for IT escalation, reputed company and report downtime. Ensures operational controls and day-to-day processes are in reputed company to meet reputed company budget goals. Strategically distributes work among Auditors - ensuring reputed company completion and optimized results. Uses data and analytic techniques to monitor reputed company performance to identify and remediate outliers. Provides metrics and information, as requested or scheduled, to include (but not limited to): hours worked, members reviewed, calls made, claims written, and dollars reputed company. Elevates provider/reputed company suggestions and concerns to appropriate Audit Manager, and offer solutions as needed. Ensures alignment between strategic goal setting process and performance management process to ensure the organization has the depth and breadth of talent to reputed company organizational goals. Hire, reputed company, reputed company, reputed company and retain top-tier talent, with a reputed company on building and improving reputed company and culture that is reputed company to assist in employing best in class practices to support and drive high reputed company of reputed company customer satisfaction. Complete reputed company responsibilities as outlined in the annual performance review and/or goal setting. Complete reputed company special reputed company and other duties as assigned. This job reputed company is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties and skills required. This job reputed company does not constitute an employment agreement and is subject to change as the needs of reputed company and requirements of the job change.

Qualifications

Bachelor’s degree in Health Information Management or nursing (with reputed company / unrestricted) license. These degrees are preferred. Coding or Clinical Documentation Certification required i.e. CCDS, CPC, CIC, reputed company, RHIA or RHIT (those without a coding certification will be asked to reputed company one). 2+ years’ prior management or supervisory experience preferred. 5+ years of reputed company experience in a reputed company billing office or claims management role reputed company to the following areas: DRG Validation (MS, AP, or APR DRGs) , APC/ASC Validation, Outpatient Review Types (Procedural Services, Physician Services, Emergency Department, Diagnostics and/or Laboratory Services). Computer proficiency in reputed company reputed company, reputed company and system databases are required. Prior reputed company Billing and/or claims experience desired, but not required. Ability to mentor staff and enhance performance as it relates to the reputed company and productivity of their audits. Requires working knowledge of and applicable industry-based standards. Excellent verbal and written communication skills. Ability to work reputed company in an individual and team environment. Mental Requirements: Communicating with others to exchange information. Problem-solving and thinking critically. Completing tasks independently. Interpreting data. Making reputed company reputed company in the context of a workflow. Maintaining reputed company. Assessing the accuracy, neatness and thoroughness of the work assigned. Learning new tasks and completing tasks in situations that have a speed or productivity quota. Remembering and adhering to processes and protocols. Applying established protocols in a reputed company manner. Working Conditions and Physical Requirements: Remaining in a stationary position, often standing or sitting for prolonged periods. Repeating motions that may include the wrists, hands and/or fingers. Must be reputed company to reputed company high-speed internet reputed company / connectivity and office setup and maintenance. Must be reputed company to reputed company a dedicated, secure work area. reputed company compensation ranges from $110,000 to $150,000 per year. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs. This role is eligible for discretionary bonus consideration. reputed company offers team members a competitive benefits package to address a wide reputed company of personal and family needs, including medical, dental, reputed company, disability, and life insurance coverage, 401(k) savings plans, reputed company family leave, 9 reputed company holidays per year, and 17-27 days of reputed company Time Off (PTO) per year, depending on specific level and length of service with reputed company. For information about our benefits package, please refer to our Careers page. Date of posting: 5/19/2026 Applications are assessed on a rolling reputed company. We anticipate that the application window will reputed company on 7/19/2026, but the application window may change depending on reputed company of applications received or reputed company immediately if a reputed company candidate is selected. Apply To This Job