• 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 • 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

• Conducts internal and external timely operational, compliance, and financial audits of divisions, departments, providers, and activities of the corporation • 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 • Reviews findings and identifies recommendations to correct deficiencies and methods for process improvements • Examines and evaluates financial and information systems, recommending controls to ensure system reliability and data integrity • Conducts special audit studies for management to discover controls for fraud prevention • Prepares reports of findings and recommendations for management

Role Description The Funding Quality Assurance (QA) Auditor supports the Funding Department by performing detailed audits, ensuring accuracy, and maintaining compliance across all funding related processes. This role is responsible for reviewing daily operational outputs, identifying discrepancies, and helping maintain a high standard of data integrity. As the department’s audit program expands, the QA Specialist will take on additional audit responsibilities, including more complex funding and reimbursement workflows. Essential Functions - Audit Daily ACH Files: Review and validate daily ACH files to ensure accuracy, completeness, and alignment with internal and client requirements. - Monitor Undelivered Emails: Track undelivered or bounced funding related emails, determine root causes, and ensure proper resolution. - Email Assignment and Routing: Review incoming funding inbox emails and accurately assign them to the appropriate Funding Coordinator based on content, client, and workflow type. - Stop Loss Reimbursement Audits: Audit stop loss reimbursement applications, ensuring documentation accuracy, correct calculations, and adherence to carrier and internal guidelines. - Additional Funding Process Audits: Participate in the development and execution of new audit procedures as the department grows, including but not limited to: - Funding request accuracy - Refund processes - Client specific funding workflows - Compliance driven audit initiatives - Process Improvement Support: Identify trends, recurring issues, and opportunities for process improvement. Collaborate with leadership to refine workflows and strengthen internal controls. - Other duties as assigned. Qualifications - Bachelor's degree or equivalent work experience required. - 3+ years’ experience in health insurance, TPA operations, or a related financial/administrative field required; background in funding, claims, stop loss, or financial auditing strongly preferred. - Familiarity with TPA systems, funding workflows, reimbursement processes, and/or quality assurance practices. - Strong analytical skills with the ability to review data, identify discrepancies, and clearly document findings. - High attention to detail with a quality driven mindset focused on accuracy, compliance, and continuous improvement. - Excellent organizational and time management skills; ability to manage multiple priorities in a fast paced environment and work independently. - Effective written and verbal communication skills, with the ability to collaborate across teams, including Funding Coordinators and leadership. - Adaptable and comfortable with evolving responsibilities and new processes. - Demonstrate professionalism and confidentiality in handling sensitive information. - Proficient in Microsoft Office (Excel, Outlook, Teams) and general data review tools. Physical Demands This is a standard desk role requiring extended sitting and computer work. Work Environment Remote. Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home; while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive. Benefits - Medical, Dental, Vision, Life and Disability Insurance - Generous Paid Time Off - Tuition Reimbursement - EAP - Technology Stipend

Role Description Responsible for educating and training WVU Healthcare Coding Staff as directed by Coding Managers. Will also oversee or perform the overall auditing and education plans for the Coding staff. This position will perform coding quality audits, provide ongoing feedback and education. This position utilizes various coding classifications; ICD-10-CM, ICD-10-PCS, CPT, and other references and software to ensure accurate coding and MS-DRG, HCC and APR-DRG assignment. Qualifications - Graduate of a Health Information Technology (HIT) or equivalent program AND Five (5) years of coding experience; OR - Graduate of a Medical Coding Certification Program AND Five (5) years of coding experience; OR - High School Diploma or Equivalent AND Eight (8) years of coding experience. - Certification in ONE of the following: - Registered Health Information Administrator (RHIA) - Registered Health Information Technician (RHIT) - Certified Outpatient Coder (COC) - Certified Coding Specialist (CCS) - Certified Professional Coder (CPC) Requirements - Bachelor’s degree in Health Information Management or related field (preferred). - Extensive experience in ICD-10-CM, ICD-10-PCS, CPT, and MS-DRG, HCC and APR-DRG assignment for Positions and multi-specialty coding, E&M coding, procedural/surgical coding. - Knowledge of governmental billing and coding regulations including the “Teaching Physician Guidelines” for Professional Coding Positions (preferred). - Previous supervisory or project management experience (preferred). Core Duties and Responsibilities - Manages activities of designated coding personnel in training for WVU Healthcare and assures the monitoring and reporting of respective employee’s developmental activity. - Manages quality improvement audits and training of designated coding staff. - Acts as expert coding resource to coders, clinical documentation improvement, providers and revenue cycle, specialty groups and meetings. - Acts as Super user for all Coding-related Electronic Medical Record Systems necessary for complete and accurate coding and EMR Data Governance. - Develops and maintains coding related policies, procedures, query development, work queues and training materials in conjunction with management. - Communicates with Coding Staff, Medical Staff, Physician Advisor, Department Chairman, and Department Administrators. - Organizes, facilitates, performs, tracks, trends, and reports on internal quality reviews. - Designs and uses audit tools (i.e ROC) to monitor the accuracy of coding, documentation gaps, and billing performed by Coding Specialists. - Coordinates audits performed by outside agencies, acting as a liaison between agency and HIM personnel. - Coordinates coding/documentation denial reviews and facilitates appeal letter formation. - Communicates regularly with the Coding Leadership on activities, problems, coding and/or documentation issues and pending audits. - Ensures audit (external and internal) recommendations are completed. - Extracts and analyzes from various sources then develops action plan when necessary. - Assists with on-boarding of new Coding Specialists regarding coding/quality related policies, audits and initiatives. - Updates Coding Specialists on compliance and other regulatory changes. - Keeps abreast of coding changes, state and federal regulations and coding resources. - May be responsible for development and design of the curriculum for the WVU Healthcare Coding Certificate Program. Physical Requirements - Must be able to sit for long periods of time. - Must have visual and hearing acuity within the normal range. - Must have manual dexterity needed to operate computer and office equipment. - Must be able to lift, push or pull 10-20 pounds. Working Environment - Standard office environment. - Visual strain may be encountered in viewing computer screens, spreadsheets, and other written material. - May require travel. Skills and Abilities - Excellent written and verbal communication skills. - Knowledge of related provider healthcare compliance, revenue cycle operations, and auditing techniques. - Ability to mentor, educate and train others. - Ensure quality and productivity standards. - Ability to handle high stress and critical situations in a calm and professional manner. - Ability to concentrate and maintain accuracy during constant interruptions. - Independent decision-making ability. - Ability to prioritize job duties. - Adaptability to changes in the workplace and work assignments. - Organizational and time management skills. - Knowledge of anatomy, physiology and medical terminology. - Analytical and problem-solving skills. - Proficiency in office software programs, including medical record and billing systems. - Ability to analyze complex data and reports. Additional Job Description - Scheduled Weekly Hours: 40 - Shift: Exempt/Non-Exempt: United States of America (Exempt) - Company: SYSTEM West Virginia University Health System - Cost Center: 539 SYSTEM HIM Provider Based Coding Analysis