The Clinical Compliance Auditor at Sevita is responsible for collaborating with Operations and Revenue Cycle to audit and monitor compliance requirements across all Company business units and service lines. This role involves ensuring that clinical audit standards and procedures are in line with legal and regulatory requirements, payer expectations, and internal standards. The auditor executes clinical audits to identify gaps and recommend changes to clinical practices for optimal care delivery, and contributes to compliance-related projects.

Compliance Clinical Auditor

Clinical Compliance Auditor

The Vendor Compliance Auditor at Capstone Logistics, LLC is responsible for taking pictures of compliance violations, working early morning or second shifts, possibly on weekends, and working in multi-temp environments. This role involves multiple software applications for data entry, strong communication skills, and detailed orientation. The auditor will generate reports for review and process improvement, and must be self-motivated with the ability to work with limited supervision.

Vendor Compliance Auditor

The Clinical Provider Auditor I at Elevance Health is responsible for identifying issues and/or entities that may pose potential risk associated with fraud and abuse. This role involves examining claims for compliance with relevant billing and processing guidelines, conducting analysis of claims and medical records prior to payment, and collaborating with various internal areas to address matters of mutual concern. The position offers a hybrid work model, requiring candidates to live within 50 miles of an Elevance Health PulsePoint location.

Clinical Provider Auditor I

The Coding Compliance Auditor at Dignity Health Medical Foundation is responsible for conducting professional fee audits on providers and coding department staff to ensure services are entered into the billing system and coded correctly according to established guidelines. This role involves providing education to improve clinical documentation and accurate code assignment, creating coding training for continuous education, and identifying coding trends to recommend improvements.

Coding Compliance Auditor

The Clinical Provider Auditor II at Elevance Health is responsible for identifying issues and/or entities that may pose potential risk associated with fraud and abuse. This role involves examining claims for compliance with relevant billing and processing guidelines, conducting analysis of claims and medical records, and collaborating with various internal areas to address fraud and abuse concerns. The position offers a hybrid work model, requiring candidates to live within 50 miles of an Elevance Health PulsePoint location.

Clinical Provider Auditor II

The Hospital Auditor at BlueCross BlueShield of South Carolina is responsible for identifying, researching, and investigating providers for aberrant and abusive billing practices against the company and its subsidiaries. This role involves analyzing hospital accounting records and credit reports for overpayments and fraudulent billing, conducting onsite audits of hospitals and provider facilities, and developing comprehensive financial strategies and audit programs. The position is a work-at-home role that may be subject to change based on business needs and employee performance.

MSP Hospital Auditor

Hospital Auditor

The Hospital Auditor at Palmetto GBA, LLC is responsible for identifying, researching, and investigating providers for aberrant and abusive billing practices against the company and its subsidiaries. This role involves analyzing hospital accounting records and credit reports for overpayments and fraudulent billing, conducting onsite audits of hospitals and provider facilities, and developing comprehensive financial strategies and audit programs. The position is a work-at-home role that may be subject to change based on business needs and employee performance.

Forvis Mazars is seeking an Associate Auditor, ideally an accounting student striving for CPA eligibility, for a full-time position. The role involves using critical thinking abilities to help clients solve problems and building rewarding business relationships. Responsibilities include completing audit testing, working with client personnel to reconcile account differences, analyzing financial data, and participating in client meetings. The position offers the opportunity to develop technical skills and shape your career path with guidance from experienced staff and management.

ASSOCIATE AUDIT OCTOBER 2025

Associate Auditor

The Quality Improvement Auditor (Clinical) at Actalent leads medical record audits, monitors and analyzes clinical documentation, and modifies business processes to measure member outcomes. This role involves assessing provider performance and quality of care through clinical case reviews, performing quantitative and statistical analysis of performance data, and coordinating with internal teams for audit requests. The position is remote and requires a Bachelor's degree in Nursing or a related field, along with 3+ years of nursing or quality improvement experience.

Quality Improvement Auditor (Clinical)

Practice Resources, LLC is seeking a full-time Remote Internal Medical Coding Auditor to review medical documentation from physicians and other healthcare providers to validate modifiers, diagnostic and procedure codes for symptoms, diseases, injuries, surgeries, and treatments according to official classification systems and standards. The role involves experience with coding/auditing multi-specialty accounts, conveying audit results to management, participating in coding team meetings, and maintaining productivity standards.

Remote Internal Medical Coding Auditor

Internal Medical Coding Auditor

The Claims Auditor at Delta Dental of Michigan, Ohio, and Indiana is responsible for analyzing, adjudicating, and processing dental claims to finalize non-clinical determinations using policies, procedures, and bypasses. This role involves reviewing member's group coverage, using various sources to obtain information needed for claim determinations, and ensuring accurate payment amounts. The position is fully remote and is part of an organization that works to improve oral health through benefit plans, advocacy, and community support.

Claims Auditor

The Diagnosis Related Group Clinical Validation Auditor is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs billed and reimbursed. This role specializes in reviewing Diagnosis Related Group (DRG) paid claims, utilizing advanced ICD-10 coding expertise, clinical guidelines, and industry knowledge to substantiate conclusions. The position operates within a hybrid model, requiring candidates to live within 50 miles of a PulsePoint location for office work.

Diagnosis Related Group Clinical Validation Auditor

As an Ethical Auditor at QIMA, you will be responsible for auditing the manufacturing sites of clients' suppliers, focusing on labor rights, health and safety, environmental security, and other areas according to international standards or client procedures. This role requires vigilance, integrity, and the ability to record detailed findings in reports. The position is open to candidates based anywhere within the US and involves contributing expertise in client meetings and suggesting improvements for Operations projects.

Ethical Auditor (CSCA)

Ethical Auditor

The Clinical Nurse Auditor, HEDIS at Providence Health Plan is responsible for conducting clinical quality audits for the Quality Department. This role involves identifying and coordinating clinical audits to determine potential areas for quality improvement within the PHP network, collecting data for the HEDIS program, conducting audits, and organizing data to identify opportunities for improvement. The position is temporary, per diem, and non-benefitted, affiliated with Providence Health Plan in Beaverton, Oregon.

Clinical Nurse Auditor, HEDIS *Remote*

Clinical Nurse Auditor, HEDIS

The Coding Auditor - Outpatient at Northwell Health conducts coding audits to optimize diagnosis related groupings, develops and implements coding instruction classes, and prepares coding guidelines. This role involves implementing coding changes, providing ad-hoc education to the coding staff, and ensuring compliance with federal and state coding guidelines. The position requires a Bachelor's degree or equivalent, current coding credential, and 1-3 years of relevant experience.

Coding Auditor - ED/ASU (remote)

Coding Auditor - Outpatient

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Clinical Compliance Auditor Jobs in Lexington, NC Hiring Now

Compliance Clinical Auditor

Vendor Compliance Auditor

Clinical Provider Auditor I

Coding Compliance Auditor

Clinical Provider Auditor II

MSP Hospital Auditor

MSP Hospital Auditor

ASSOCIATE AUDIT OCTOBER 2025

Quality Improvement Auditor (Clinical)

Remote Internal Medical Coding Auditor

Claims Auditor

Diagnosis Related Group Clinical Validation Auditor

Ethical Auditor (CSCA)

Clinical Nurse Auditor, HEDIS Remote

Coding Auditor - ED/ASU (remote)