• Independently plan audits • Conduct audits in accordance with relevant standards • Prepare for and follow up on audit processes • Prepare audit reports in German and English • Lead on-site audits

Role Description The Nurse Auditor is an expert clinician in the related specialty practice that combines clinical practice with education and leadership. Responsibilities include: - Overseeing and performing the concurrent, pre-bill and assisting with retrospective audits of billed charges against medical records to identify missing revenue. - Identifying opportunities related to charging properly and determining the root cause. - Working with the leadership team to develop appropriate and standard charging and documentation practices. - Participating in the annual departmental charge master review. - Assisting in the training of clinical staff on changes in the chargemaster. Estimated salary range for this position is $80,516.80 - $107,087.34 / year depending on experience. Qualifications - Degrees: Bachelors. - Licenses & Certifications: Registered Nurse. - Minimum 3 years of clinical experience. - Procedural coding, billing and audit experience required. - Extensive knowledge of laws, regulations and rules applicable to billing government payers is helpful. - Demonstrated ability to be self-directed with excellent organization, analytical and interpersonal skills. - Excellent oral and written communications skills. - Strong attention to detail. - National certification in related department specialty preferred. - Minimum Required Experience: 4 Years. Benefits - Career growth and development opportunities, with clear pathways and ongoing support. - Comprehensive health and wellness resources that go beyond traditional benefits. - A wellness program that can help employees eliminate their medical plan deductible, reducing out-of-pocket healthcare costs. - Tuition reimbursement to support continued learning and advancement. - And so much more. Company Description Baptist Health is the region's largest not-for-profit healthcare organization, with 12 hospitals, over 29,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties. With internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences, Baptist Health is supported by philanthropy and driven by its faith-based mission of medical excellence. For 26 years, we've been named one of Fortune's 100 Best Companies to Work For, and in the 2025-2026 U.S. News & World Report Best Hospital Rankings, Baptist Health was the most awarded healthcare system in South Florida, earning 63 high-performing honors. What truly sets us apart is our people. At Baptist Health, we create personal connections with our colleagues that go beyond the workplace, and we form meaningful relationships with patients and their families that extend beyond delivering care. Many of us have walked in our patients' shoes ourselves and that shared experience fuels our commitment to compassion and quality. Our culture is rooted in purpose, and every team member plays a part in making a positive impact – because when it comes to caring for people, we're all in.

Role Description WCF Insurance is growing, and the Premium Audit department has an immediate opening for someone who can demonstrate the WCF Insurance values to join our team as an Associate Premium Auditor. This position is open to both internal and external candidates. This is a full-time, primarily remote, and an exempt position open to qualified candidates residing in Northern Utah. Regular travel to policyholder locations within the assigned geographic area is required. - The Associate Premium Auditor meets with policyholders to review payroll and accounting records to determine final premium. - Prepares detailed reports and clearly communicates findings, including changes in payroll, premium, and classification codes. - Conducts all work with a focus on WCF's values and provides exceptional customer service. - Manages workload and priorities to ensure that production, quality, and timeliness standards are met. - Works closely with cross‑functional partners at WCF, including Underwriting and Marketing, through all phases of the policy life cycle. Qualifications - Bachelor's degree, preferably in accounting, finance, or business administration. - Accounting or finance experience preferred. - Excellent oral and written communication skills. - Ability to analyze financial statements and payroll records. - Basic computer skills, including proficiency in Word and Excel. - Strong organizational skills. - Internal candidates should have 6 months in their current position, acceptable job performance, and must notify their current supervisor that they have applied for the position. Benefits - Medical, Dental, and Vision insurance. - Company paid life insurance. - 401K with a generous 6% employer match. - Employee Assistance Program (EAP). - Time off to volunteer in the local community. - All employees earn 4 weeks of vacation in their first year. Company Description WCF strives to provide an excellent work experience and cultivate an inclusive environment where anyone who embodies our values will thrive. WCF Insurance provides equal employment opportunity to all qualified applicants and employees regardless of race, color, religion, sex, age, national origin, veteran status, disability that can be reasonably accommodated, or any other basis prohibited by federal, state, or local law.

Role Description As a Medical Reviewer, you will be auditing medical records to evaluate the accuracy of medical coding and health plan policies for our Fraud, Waste & Abuse clients. - Conducts audit of medical records and healthcare claims assessing the accuracy of medical coding and determining compliance with appropriate policies, procedures, and regulations. - Prepares and submits detailed reports on audit findings making recommendations to correct deficiencies and/or practice or process improvements. - Conducts medical policy and other relevant research in support of review findings. - Uses knowledge of healthcare coding conventions, areas of vulnerability, reimbursement methodologies, and the ability to identify suspicious patterns in medical record documentation. - Maintains current knowledge of federal, state, and individual payer policy and coding guidelines. - Participates in special projects as required. Qualifications - Bachelor’s Degree in a related discipline, or the equivalent combination of education, professional training, and work experience. - Preferred licenses: Licensed Practical Nurse (LPN), Registered Nurse (RN) - Required Credential: Certified Professional Coder (CPC, CCS, CCS-P) - 2-5 years of related experience in auditing medical records. - Computer proficiency in MS Office suite. - Excellent verbal and written communication skills. - Strong listening and observation skills. - Attention to detail and a high level of accuracy. - Effective organizational and prioritization skills with multi-tasking ability. - Ability to conduct research in support of medical review determinations. - Understanding of ICD, CPT, HCPCS, APC, DRG, Revenue Codes, NCDs, and federal and state guidelines (including CMS NCCI). - Healthcare claims experience helpful. - Works independently; collaborates well with peers and customers. - Must have no adverse actions pending or taken against him/her by any State or Federal licensing board or program. Requirements - Communicating with others to exchange information. - Assessing the accuracy, neatness, and thoroughness of the work assigned. - Must have the ability to positively handle/manage stress, such as high work volume and frequent change. Physical Requirements and Working Conditions - This is a work-at-home position (US only). - 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 able to provide a dedicated, secure work area. - Access to high-speed internet is required (all other equipment will be provided). - No adverse environmental conditions are expected. Benefits - Base compensation ranges from $70,000 to $91,000 per year. - Competitive benefits package including medical, dental, vision, disability, and life insurance coverage. - 401(k) savings plans. - Paid family leave. - 9 paid holidays per year. - 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. Application Information Date of posting: 6/17/2026 Applications are assessed on a rolling basis. We anticipate that the application window will close on 8/17/2026, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.