• Conducts internal and external timely operational, compliance, and financial audits • Identifies, documents, and evaluates business risks • Drafts recommendations to limit risks and improve processes • Writes audit reports for corporate executive management • Collects and analyzes data to detect deficient controls, duplicated effort, fraud, or non-compliance • Conducts testing of corrective actions • Develops detailed reports on each audit conducted • Examines and evaluates financial and information systems • Conducts special audit studies for management • Prepares reports of findings and recommendations for management • Assists other auditors in completing their assignments

• Conducts internal and external timely operational, compliance, and financial audits of divisions, departments, providers, and activities of the corporation including evaluation of internal controls • Identifies, documents, and evaluates business risks • Documents issues, the causes of those issues, and their effects on the process/function and the corporation • Drafts recommendations to limit risks and improve processes, functions and activities • Writes audit reports for corporate executive management that clearly and effectively convey engagement evaluations, conclusions, and recommendations • Collects and analyzes data to detect deficient controls, duplicated effort, fraud, or non-compliance with laws, regulations, and management policies • Conducts testing of corrective actions as identified • Develops detailed reports on each audit conducted • Reports include a review of findings and an identification of recommendation to correct any deficiencies and methods for improvement to processes • Examines and evaluates financial and information systems, recommending controls to ensure system reliability and data integrity • Conducts special audit studies for management, such as those required to discover controls for prevention of fraud • Prepares reports of findings and recommendations for management • Assists other auditors in completing their assignments as a means of maximizing audit efficiency and thus reducing lost time and involvement of corporate personnel

• Beoordelen of een kwaliteitssysteem van een organisatie voldoet aan actuele normen • Uitvoeren van audits inclusief vooronderzoeken en eventuele opvolgingsbezoeken • Mondeling toelichting geven over de bevindingen direct na het uitvoeren van de audit • Schrijven van rapportages van de uitgevoerde audits • Op de hoogte blijven van ontwikkelingen rond food-standaarden • Kennis en praktijkervaring uitwisselen met je collega’s Auditoren Food

• Auditing claims for medically appropriate services provided in skilled nursing facility settings while applying appropriate medical review guidelines, policies and rules. • Document all findings referencing the appropriate policies and rules. • Generate letters articulating audit findings. • Support audit findings during the appeals process if requested. • Work collaboratively with the audit team to identify and obtain approval for particular vulnerabilities and/or cases subject to potential abuse. • Work in partnership with our clients, CMD colleagues, and other contractors on improving medical policies, provider education, and system edits. • Keep abreast of medical practice, changes in technology, and regulatory issues that may affect our clients. • Work with the team to minimize the number of appeals; Suggest ideas that may improve audit workflows. • Assist with QA functions and training team members. • Participate in establishing edit parameters, new issue packets and development of Medical Review Guidelines. • Interface with and support the Medical Director and cross train in all clinical departments/areas. • Other duties as required to meet business needs.