Role Description - Support the performance of internal audits across various engagement areas, including securities business, risk management, and others. - Draft audit reports, present audit findings, and monitor the timely implementation of agreed remediation actions. - Contribute to the continuous enhancement of Internal Audit processes. - Collaborate closely with diverse departments such as Compliance, Risk, Product, Finance, Client Service, Capital Markets, and Operations. - Acquire comprehensive knowledge of vital operations within a rapidly expanding FinTech environment. Qualifications - Your work style is defined by a methodical, independent, and hands-on approach. - You demonstrate the capacity to rapidly comprehend complex new subjects. - You hold an academic degree in Law, Finance, Economics, or a related discipline. - You have acquired initial professional experience within the financial services industry, such as at an investment firm, bank, or reputable audit company. - Maintaining a strong sense of accountability, particularly regarding confidential information and data, is essential to you. - You exhibit excellent interpersonal and communication skills, with the specific ability to navigate potentially confrontational scenarios. - You are committed to staying informed about evolving regulatory and industry trends. - You are a reliable, ethical, and diligent contributor to the team. - You have professional fluency in both English and German. Benefits - Be part of one of the fastest-growing and most visible Fintech startups in Europe, creating innovative services that have a substantial impact on the lives of our customers. - Work with an international, diverse, inclusive, and ever-growing team that loves creating the best products for our clients. - Be productive with the latest hardware and tools. - Learn and grow by joining our in-house knowledge sharing or career development sessions and spending your individual Education Budget. - Learn and experience German culture first hand by joining our free German language classes. - International relocation support is provided if required. - Opportunity to work from abroad. - Benefit from an attractive compensation package and from the company pension scheme. - Monthly contribution of 50% for the ‘Deutschland Jobticket’. - Say goodbye to order commissions and say hello to your complimentary subscription of Scalable Capital's PRIME+ Broker. - Enjoy flexible and discounted sports activities with Urban Sports Club.

Role Description Take ownership of audit engagements within the IT and ISMS domains. - Carry out independent audits in designated focus areas, specifically IT and ISMS, as outlined in the audit plan and supported by the Internal Audit Team. - Manage the full audit lifecycle, from documenting procedures and drafting reports to communicating findings and tracking the execution of remediation steps. - Foster strong collaborative relationships across various business units, particularly with Operations, Product, and Engineering. - Assist in the ongoing development and optimization of internal audit methodologies. - Acquire comprehensive knowledge of vital operations within a rapidly expanding FinTech environment. Qualifications - You possess a degree in Computer Science, Business Informatics, Business Administration, Economics, or a related discipline. - You bring professional experience within the financial sector, having worked at a bank or a reputable auditing firm. - You have a background in internal or external auditing specifically within financial services. - You demonstrate expertise in IT/ISMS audits and are well-versed in standards such as ISO 27001, EBA guidelines, BSI standards, and DORA. - You hold a CISA or equivalent certification, or are keen to obtain one. - You exercise a high level of responsibility, particularly when handling sensitive information. - You communicate effectively and can navigate challenging situations with professional diplomacy. - You operate with a systematic, independent, and pragmatic mindset. - You are highly organized and can quickly master new subject matter. - You are proactive in keeping pace with the latest industry developments and regulatory requirements. - You are a reliable and conscientious team player who acts with integrity. - You have professional fluency in both German and English. Benefits - Be part of one of the fastest-growing and most visible Fintech startups in Europe, creating innovative services that have a substantial impact on the lives of our customers. - Work with an international, diverse, inclusive, and ever-growing team that loves creating the best products for our clients. - Be productive with the latest hardware and tools. - Learn and grow by joining our in-house knowledge sharing or career development sessions and spending your individual Education Budget. - Learn and experience German culture first hand by joining our free German language classes. - International relocation support is provided if required. - Opportunity to work from abroad. - Benefit from an attractive compensation package and from the company pension scheme. - Monthly contribution of 50% for the ‘Deutschland Jobticket’. - Say goodbye to order commissions and say hello to your complimentary subscription of Scalable Capital's PRIME+ Broker. - Enjoy flexible and discounted sports activities with Urban Sports Club.

Title: Clinical Auditor/Analyst (Remote- Fraud, Waste and Abuse Location: Remote United States Job ID: 7942982042 Status: Full-Time Regular/Temporary: Regular Shift: Day Job Work Arrangement: Remote Facility: UPMC Health Plan Department: Fraud, Waste & Abuse Union Position: No Salary Range: $ 32.85-56.83 USD Job Description: UPMC Health Plan has an exciting opportunity for a Clinical Auditor/Analyst position in the Fraud, Waste & Abuse department. This is a full time position working Monday through Friday daylight hours and will be a remote position. The Clinical Auditor/Analyst is an integral part of the Special Investigations Unit (SIU) and is responsible for conducting clinical audits and reviews regarding the analysis of care and services related to clinical guidelines, coding requirements, regulatory requirements, and resource utilization. The Clinical Auditor/Analyst creates, maintains and analyzes auditing reports related to their assigned work plan and communicates the results with management. Other responsibilities include but are not limited to analysis of controlled substance prescribing and utilization to identify potential clinical care issues, prepayment review of claims, and prepayment review of unlisted codes. Claims analysis and the use of fraud and abuse detection software tools will be an integral part of the function of this position. Responsibilities will involve working in collaboration with appropriate Health Plan departments including Quality Improvement, Legal, and Medical Management to facilitate the resolution of issue or cases. Responsibilities may involve multiple line of business focused reviews, or ad hoc reviews as needed; analysis of billing by providers/physicians, and providing trending, analysis and reporting of auditing data. The Clinical Auditor/Analyst will routinely interact with providers, law enforcement and/or regulatory entities in the course of their duties. Responsibilities: - Respond to fraud, waste, and abuse referrals and/or complete data analysis and related audits as assigned. - Utilize fraud detection software to assess and monitor for potential FWA. - Review and analyze claims, medical records and associated processes related to the appropriateness of coding, clinical care, documentation, and health plan business rules. - Provide a clinical opinion for special projects or various issues including appropriate utilization of controlled substances, prescribing of controlled substances, or medically appropriate services. - Query medical and/or pharmacy claims and conduct a risk assessment by performing data analysis and applying applicable coding guidelines, - Health Plan policies and any applicable National Coverage Determination (NCD) or Local Coverage Determination (LCD).Evaluate referrals from Pharmacy Benefit Manager (PBM) by analyzing medical and pharmacy claims and associated clinical documentation in HealthPlaNET, Mars, Epic and/or Cerner. - Complete audits by utilizing standard coding guidelines and principles and coding clinics to verify that the appropriate CPT codes/DRGs were assigned and supported in the medical record documentation. - Attend in person or virtual recipient restriction hearings. - Review Medical Pended Queue claims to understand and resolve claim referral issues through research and interaction with other Health Plan Departments including Medical Management, Medical Directors, various committees, and other appropriate Health Plan departments. - As necessary, assist in the development of new policies concerning future Health Plan payment of identified issue. - Assess, investigate and resolve low to intermediate issues. - Write concise written reports including statistical data for communication to other areas of UPMC Health Plan and to communicate with department heads for identification of various problem issues, how they affect the Health Plan, and to make recommendations for resolution of the issue. - Identify error trends to determine appropriate training needs and suggest modifications to company policies and procedures. - Conduct provider education, as necessary, regarding audit results. - Communicate effectively with Medical Directors and ancillary departments as necessary to address issues and concerns. - Understand customers including internal Health Plan Departments (i.e. Claims staff, Customer Service, Marketing, etc.) and external customers (i.e. Health System Internal Audit, Client Audit teams) to understand issues, identify solutions and facilitate resolution. - Serve as an SIU representative at internal and external meetings, document and present findings to SIU Staff and document as appropriate in the SIU FWA Case Management Database. - Assist in the development and revision of SIU policies and procedures. - Identify trends for improvements internally, such as claims payment, to determine appropriate training needs and suggest modification to company policies and procedures. - Participate in training programs to develop a thorough understanding of the materials presented. - Obtain CPE or CEUs to maintain nursing license, and/or professional designations. - Design and maintain reports, auditing tools and related documentation. - Maintain or exceed designated quality and production goals. - Maintain employee/insured confidentiality and adhere to HIPAA regulations. Qualifications: - Registered Nurse (RN). - Five years of clinical experience. - Two years of fraud & abuse, auditing, case management, quality review or chart auditing experience required. - Ability to analyze data, maintain designated production standards, and organize multiple projects and tasks. - In-depth knowledge of medical terminology, ICD-10 and CPT-4 coding. Knowledge of health insurance products and various lines of business. - Detail-oriented individual with excellent organizational skills. - Keyboard dexterity and accuracy. - High level of oral and written communication skills. - Proficiency with Microsoft Office products (Excel, Access, OneDrive, OneNote and Word). Licensure, Certifications, and Clearances: AAPC or AHIMA Certified (CPC, CPMA, CIC, CCA, CCS, CCS-P) or AHFI designation preferred. - Registered Nurse (RN) *Current licensure either in the state where the facility is located or, if the facility is in a state covered by the multistate Nursing Licensure Compact (NLC) agreement, a multistate license issued by a participating NLC state. Hires and current employees working on an out-of-state NLC license who later change their residency to the state where the facility is also located will have 60 days upon changing their residency to apply for licensure within that state. UPMC is an Equal Opportunity Employer/Disability/Veteran

• Review and analyze escrow account reconciliations submitted by title agents. • Identify potential risk factors, irregularities, or practices that could impact agents or the company. • Communicate findings and recommendations to agents and management. • Identify outstanding premium or search revenue reflected in reconciliations and report findings to management. • Review in-house closings and agent escrow accounts as requested. • Assist with audits of prospective and terminated agents. • Prepare detailed written audit reports and maintain organized audit workpapers. • Partner with internal stakeholders to support risk mitigation and compliance efforts.