• Perform regularly scheduled in plant audits as requested by the Regional Inspection Manager. • Perform on-site scheduled audits as requested by Regional Inspection Manager. • Perform product sampling as requested by Regional Inspection Manager. • Continually monitor the client’s implementation of approved quality systems. • Continually evaluate and communicate the status of each client’s quality system to the Regional Inspection Manager. • All inspection reports will be sent to the Regional Inspection Manager for review by the end of each month. • Establish excellent relationships with States and HUD to ensure we are respected as a leader and partner. • Ensure all applicable ICC NTA procedures are consistently followed in the execution of inspection jobs. • Continually identify, recommend, and pursue opportunities for process improvements within the Department and ICC NTA. • Promote effective communication throughout the organization. • Identify opportunities and recommend actions that will enhance communication among all employees. • Contribute on an ongoing basis, insights and ideas for resolving repetitive issues as they arise in the field by establishing and maintaining a consistent line of communication with Inspection Managers. • Perform other duties, responsibilities, and special assignments as directed by the Regional Inspection Manager.

• Lead ITGC and application control testing efforts • Guide and review work completed by junior team members • Perform walkthroughs, testing, and documentation for SOC 2, SOC 1, and HIPAA engagements • Identify control gaps and provide recommendations for remediation • Maintain strong client relationships through clear and proactive communication • Ensure timely progress updates and escalate issues to management

Role Description The Outpatient Coding Compliance Auditor performs audits of outpatient facility (OPPS) coding to ensure accurate assignment of ICD-10-CM diagnoses, CPT/HCPCS codes, modifiers, and facility E/M levels (ACEP or client-specific). This role reviews coding for alignment with medical record documentation and established guidelines, ensuring compliance with applicable laws, regulations, and billing standards while effectively communicating findings to stakeholders. The Auditor also analyzes audit outcomes to identify trends, determine root causes, and pinpoint opportunities for improvement, as well as assess the effectiveness of corrective actions. Additionally, as part of the Compliance Workplan, the Auditor participates in quality assurance (QA) coding oversight, conducts independent reviews, and supports organizational compliance initiatives. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Perform coding compliance and quality audits in support of Optum Insight Provider’s Compliance Program and client expectations - Independently analyze and interpret clinical documentation from medical records - Validate coding accuracy for outpatient facility, including E/M services, procedures, and modifiers - Identify audit findings, calculate billing error rates, and perform root cause analysis to determine drivers of non-compliance - Assess and evaluate the adequacy and effectiveness of corrective action plans, providing follow-up validation as appropriate - Clearly document audit findings and articulate results tailored to the appropriate audience - Prepare written audit analysis and summary reports, including compliance risk, trends, and recommended corrective actions - Conduct ad hoc coding and billing audits as requested - Provide compliance oversight of QA audit activities, ensuring consistency and adherence to established standards - Audit vendor coders and auditors, including offshore staff - Monitor and track evolving industry trends, regulatory updates, and government audit activities to identify potential coding and billing risk areas - Stay current with applicable coding, billing, and regulatory guidelines - Research, develop, and present targeted education based on individual, team, and systemic audit findings Qualifications - Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) or Certified Outpatient Coder (COC) - 5+ years of Outpatient Facility coding experience including: - NCCI/OCE billing edits related to outpatient services coding and billing - ICD-10-CM and CPT (including CPT-4) - ACEP Facility or similar Facility E/M matrix guidelines for outpatient facility code assignment - 5+ years of Outpatient Facility audit experience, including surgery, observation, and emergency department, including: (Strong industry knowledge of Medicare regulations and payment policies, including OPPS) Preferred Qualifications - Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) or Certified Professional Medical Auditor (CPMA) a plus - Demonstrated ability to perform independent, autonomous audit and coding review functions - Strong professional communication skills, both oral and written - Ability to prioritize and manage multiple assignments, spreadsheets, documents, and reports - Proven time management skills with consistent follow-through to completion - Proficiency with Microsoft Excel, Teams, PowerPoint, Word, and Outlook Benefits - Comprehensive benefits package - Incentive and recognition programs - Equity stock purchase - 401k contribution (all benefits are subject to eligibility requirements) Application Deadline This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

• Plan, execute and report internal audits of financial, accounting, operational and technology processes. • Assess compliance with internal policies, accounting standards, laws, regulations and applicable regulatory requirements. • Evaluate the effectiveness of internal controls, identifying risks, vulnerabilities and opportunities for improvement. • Prepare audit reports with recommendations to mitigate risks and strengthen internal controls. • Monitor implementation of action plans and validate the effectiveness of corrective actions. • Support external audits and regulatory inspections by providing evidence and following up on findings. • Contribute to continuous improvement of processes, internal controls and corporate governance. • Advise company departments on matters related to internal audit, internal controls and risk management.