Auditor Remote Jobs in Maine (US)
This page tracks remote auditor openings that are location-eligible for Maine.
This page tracks remote auditor openings that are location-eligible for Maine.
Open jobs
1,040
Hiring companies this week
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$36 - $101,000
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1040 Jobs
549 Companies
Technology-driven revenue cycle management services for healthcare providers.
• Audit inpatient cases for DRG validation • Review inpatient medical records for validation of DRG assignment • Provide detailed rationale and supporting evidence for the recommendation and findings • Utilize industry-recognized references to support their review findings, such as the ICD-10 Official Guidelines for Coding and Reporting, AHIMA Standards of Ethical Coding, AHIMA Practice Briefs related to compliant querying, and AHA Coding Clinics • Evaluate claim reimbursement potential based on coding assignment
With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees. Ranked as the number 1 hospital in Dallas-Fort Worth according to U.S. News & World Report, we invest in you with opportunities for career growth and development to align with your future goals.
Role Description Researches and resolves credit balance accounts resulting from errors in payment posting, charge entry, contractual adjustments, and overpayments. - Analyze all payer underpayments, variances and denials. - Resolves all insurance companies refund request letters received. - Work From Home (WFH): This is a work from home position. However, candidates must live in the Greater DFW area. - Shift: 8-hour days flex shift, Monday through Friday. Qualifications - High School Diploma. - 5 years' experience performing follow-up/collections, payment posting, appeals and managed care contract understanding/interpretation. - May consider education in lieu of experience. - Preferred: 2 years related work experience performing appeals and managed care contract understanding/interpretation. Requirements - Reviews patient accounts for incorrect posting and provide orientation and training for staff to contact insurance companies, patients and research insurance payments to identify and correct posting errors. - Validate and issue refunds to patients and third-party carriers for overpayment or duplicate payment, according to state regulations and contractual obligations. - Analyze payer underpayments, variances and denials. Escalate trends, make comprehensive suggestions and file professional appeals according to our contractual agreements and UT Southwestern policy. - Identifies and denies any refund request letters that are past the insurance refund deadline. - Appropriately transfer payments between invoices and/or accounts. - Communicate, approve, and reject refund requests to payers and third-party carriers, via phone call and written correspondence. - Verifies insurance is correct, update insurance demographics, rebill claims and perform appeals if applicable. - Duties performed may include one or more of the following core functions: - Directly interacting with or caring for patients; - Directly interacting with or caring for human-subjects research participants; - Regularly maintaining, modifying, releasing or similarly affecting patient records (including patient financial records); - Regularly maintaining, modifying, releasing or similarly affecting human-subjects research records. - Performs other related duties as required. Benefits - PPO medical plan, available day one at no cost for full-time employee-only coverage. - 100% coverage for preventive healthcare - no copay. - Paid Time Off, available day one. - Retirement Programs through the Teacher Retirement System of Texas (TRS). - Paid Parental Leave Benefit. - Wellness programs. - Tuition Reimbursement. - Public Service Loan Forgiveness (PSLF) Qualified Employer.
UC Health is a hospital and healthcare organization that consists of the University of Cincinnati Medical Center, its flagship facility, and the state-of-the-art West Chester Hospi
Role Description The CDI Educator/Quality Auditor will be responsible for: - Onboarding of new CDI Specialists. - Providing one-on-one, virtual, and recorded clinical documentation and coding education to the CDI team, medical providers, leadership, and other healthcare staff members. - Creating and maintaining the CDS staff education database. - Creating and delivering formal and informal education. - Tracking compliance and responding to requests for education. - Ensuring all education opportunities are available to the CDI department. The CDI Educator/Quality Auditor uses clinical knowledge, code assignment, documentation requirements, and reimbursement methodologies to: - Review the work of clinical documentation improvement specialists. - Improve documentation and patient quality, and capture severity, acuity, and risk of mortality. - Document results to track and trend the success of the overall program. - Provide educational follow-up and identify changes in medical practice that should be reflected in documentation. - Provide targeted feedback to team members on a monthly cadence based upon audit findings. Company Description
Role Description Take a senior role in planning, performing, and reporting on information technology audits across areas such as IT operations, infrastructure, information security, and IT governance. This role provides objective, risk-focused assurance on risk management practices, governance processes, and internal controls while helping ensure audit work supports business and regulatory expectations. You’ll also supervise audit work, support issue validation, and build proactive relationships with business partners. Key Accountabilities - Lead assigned IT audit projects, including scoping, planning, testing, documentation, and reporting. - Assess risks, controls, processes, and systems to support audit planning and execution. - Perform audit testing through interviews, data extraction and analysis, process design review, and evaluation of control effectiveness. - Review audit workpapers and conclusions to ensure audit objectives are met and controls are appropriately evaluated. - Partner with business leaders, Risk Management, and audit colleagues to identify emerging risks and incorporate changes into audit assessments. - Supervise and coach assigned audit staff in alignment with company policies and performance expectations. - Manage assigned issues in the centralized issue tracking system and support validation work for regulatory and audit findings. - Maintain professional and technical knowledge by staying current on audit methodology, banking processes, laws, rules, and regulations. Qualifications - Bachelor’s degree in Finance or Accounting. - 4+ years of progressive audit experience within financial services and/or information technology. - 4+ years of technical understanding of General IT Controls, IBM i, Windows/VM, Linux, Oracle, SQL, and network protocols. - Advanced Professional Certification within 1 year. - Certified Information Systems Auditor within 1 year. Requirements - Certified Public Accountant by start date. Benefits - Retirement savings including both 401(k) and Pension plans. - Paid time off to volunteer in your community. - Opportunities to connect with others through our diversity-focused Colleague Resource Groups. - Competitive salaries with professional development and advancement opportunities. - Bonus benefits including well-being programs and incentives, parental leave, an employee stock purchase plan, military benefits and much more. - Personal banking, loan, investment and insurance benefits.
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia.
Role Description Accurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient encounter visit for the purpose of appropriate reimbursement, research and compliance with federal and state regulations according to established ICD-10-CM/PCS coding and/or CPT-4 procedure coding classification systems. Qualifications - High School graduate or equivalent. Formal ICD-10-CM, ICD-10-PCS, CPT-4 training. - Associates or Bachelor’s degree. Education will be considered in lieu of experience. - Minimum of two years ICD-10-CM/ICD-10-PCS coding and abstracting experience with at a Level 1 Trauma hospital or 4 years of experience with coding inpatient hospital medical records. 2-3 Years Ambulatory coding experience. - One of the following: Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Inpatient Coder (CIC). Requirements - Must be based in EST or CST hours (cannot recruit from Hawaii, Alaska, or California). - Must have equipment. - Audits complex inpatient cases such as trauma, rehab, neurology, critical care, etc. utilizing the ICD-10-CM and ICD-10-PCS nomenclature to ensure accurate APR-DRG/SOI/ROM and POA assignment. - Accurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient. Benefits - Medical, dental & vision. - Critical Illness, Accident, and Hospital. - 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available. - Life Insurance (Voluntary Life & AD&D for the employee and dependents). - Short and long-term disability. - Health Spending Account (HSA). - Transportation benefits. - Employee Assistance Program. - Time Off/Leave (PTO, Vacation or Sick Leave). Company Description We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
• Defend Cotiviti’s recovery determinations utilizing appropriate guidelines • Review initial claim along with associated documentation • Render a decision and formulate a written response on each claim reviewed • Provide educational feedback to the audit and QA team • Maintain a minimum productivity standard as outlined for the role • Must perform duties with or without reasonable accommodation.
EXL is a global company providing business process solutions engineered to help companies streamline operations, simplify compliance, prepare for change, and cr
• Review medical records to verify services were provided as billed for Hospital Bill Audit reviews. • Identify overcharges, undercharges and unbundled items. • Identify unbundled items on the itemized bill specific to payer Unbundling Guidelines and provide references and rationale to support review findings. • Onsite Travel – Maintain timely communication with Audit Coordinator regarding scheduling, completion and submission of audits. Abide by the EXL Travel policy while making travel arrangements for onsite audits. • Scheduling Audits: Manage inventory and schedule audits timely by contacting the provider to schedule date and time to perform audits. • Report any problems in the audit process to Manager for resolution. • Comply with HIPAA and other regulations regarding the confidentiality of patient information. • Conduct all job functions and responsibilities in accordance with all company Compliance, Information Security and Regulatory policies, procedures and programs.
EXL is a global company providing business process solutions engineered to help companies streamline operations, simplify compliance, prepare for change, and cr
Role Description The Nurse Auditor conducts hospital charge audits on claims paid at percent of billed charges to verify charges are appropriate and supported by documentation in the medical record. Charge audits identify overcharges, undercharges, and unbundled items per carrier contract, industry standards, and payer reimbursement policies. - Itemized Bill Review knowledge is required with regard to Unbundling Guidelines specific to payer policy, industry standards, and Medicare Guidelines. - The nurse will also be responsible for independent scheduling requiring flexibility and possible travel to provider location. - The position requires strong clinical experience and technical skills. Salary range: $70,000 - $90,000 - 0-10% travel may be required. For more information on benefits and what we offer please visit us at EXL Careers and Benefits . The posted range is the hiring range for this role and reflects base salary across our national hiring scale. Final offers are based on several factors, including: - Candidate's skills and experience - Internal pay equity - Work location - Market conditions for the role - Specific scope and responsibilities of the position The top of the range is reserved for candidates who notably exceed the requirements; the lower end applies to those with less experience or fewer preferred qualifications. For positions based in higher-cost zones (e.g., California, New York, New Jersey), actual compensation may exceed the posted range; your recruiter will share specifics during the process. Qualifications - Strong clinical experience - Technical skills - Knowledge of Itemized Bill Review - Understanding of Unbundling Guidelines Requirements - Flexibility in scheduling - Possible travel to provider locations Benefits - Comprehensive benefits package (details on the website) Company Description EXL (NASDAQ: EXLS) is a leading data analytics and digital operations and solutions company. We partner with clients using a data and AI-led approach to reinvent business models, drive better business outcomes, and unlock growth with speed. - Founded in 1999 with core values of innovation, collaboration, excellence, integrity, and respect. - Headquartered in New York with more than 54,000 employees spanning six continents. - Specializes in industries including insurance, healthcare, banking and financial services, media, and retail. For more information, visit www.exlservice.com .
EXL is a global company providing business process solutions engineered to help companies streamline operations, simplify compliance, prepare for change, and cr
Role Description In this fully remote position as an HCD Auditor, you will apply your expert knowledge of billing HCD claims to perform extensive audit reviews. You will: - Utilize HCPCS codes, medical record review, industry, and EXL proprietary tools in the audit process. - Write professional communications documenting audit findings and supporting rationales. - Apply your extensive industry knowledge to identify audit trends and opportunities. Salary range: $55,000.00 - $70,000.00 0-10% travel may be required. Company Description EXL (NASDAQ: EXLS) is a leading data analytics and digital operations and solutions company. We partner with clients using a data and AI-led approach to: - Reinvent business models - Drive better business outcomes - Unlock growth with speed Founded in 1999, EXL has core values of: - Innovation - Collaboration - Excellence - Integrity - Respect We are headquartered in New York and have more than 54,000 employees spanning six continents. EXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates. EXL will only extend a job offer after a candidate has gone through a formal interview process with members of EXL’s Human Resources team, as well as our hiring managers. Clients choose EXL as their transformation partner for many reasons: - Geographic diversity makes talent all over the world instantly accessible. - Digital accelerators enable unmatched speed-to-value, letting you realize results fast. - Our people, including 1,500 data scientists dedicated to our generative AI practice, truly set us apart. - More than twenty years of experience in delivering business services. - Stellar client references and a solid balance sheet are reassuring to our C-suite clients. Find out for yourself why clients, employees, and analysts think we’re some of the best in the business. Contact us to see how we can help you achieve your goals.
CNO Financial Group, Inc. (NYSE: CNO) secures the future of middle-income America. CNO provides life and health insurance, annuities, financial services and workforce benefits solutions through our family of brands, including Bankers Life, Colonial Penn, Optavise and Washington National. Our customers work hard to save for the future, and we help protect their health, income and retirement needs with 3.3 million policies and more than $38.3 billion in total assets. We are financially strong and well positioned for continued growth, grounded in our core values of People Focused, Integrity, Customer Driven, and Excellence. We have offices in more than 220 communities in the U.S., including our headquarters in Carmel, Indiana, and corporate offices in Birmingham, Chicago, Orlando and Milwaukee. At CNO Financial Group, we’re always looking forward—to the security and stability we help create for our insurance brands’ customers, and the growth we create within our own company. We're looking for ambitious people who want to do more. We'll provide you with opportunities to grow your skills through challenging professional experiences. If you're looking for a culture that encourages development, helps you reach your potential, and rewards you for your contribution, then CNO Financial Group is right for you. For more information, visit CNOinc.com.
Role Description - Assisting in identifying preliminary audit scoping, including performing technical research, conducting stakeholder interviews, and preparing audit questionnaires. - Performing walkthroughs, document risk, and controls documentation. - Executing specific audit procedures and preparing work, documenting the procedures performed. - Evaluating the adequacy and effectiveness of internal controls to identify key controls, weaknesses, and compensating controls, identifying areas for improved control, cost savings, and operational efficiency. - Drafting audit recommendations for inclusion in audit reports and memos for review by Audit Manager utilizing scoping documentation completed during planning phase and testing results completed during fieldwork phase. - Performing follow-up work on past audit recommendations as directed by audit management to determine adequacy of corrective actions taken by management; to be completed within SLA. - Completing work timely and accurately to ensure project milestones are achieved, implementing effective problem-solving skills to meet project objectives. - Applying judgment to ensure professional standards are satisfied, with guidance from colleagues. - Identifying matters and issues that should be reviewed and/or escalated to higher levels of management. - Completing special studies and projects as may be assigned. Qualifications - Bachelor’s degree in Information Technology, Computer Science, Accounting, Finance or a related field. - 2 years of experience in IT audit (internal or external), IT Compliance, IT Governance, or IT Risk Management. - Familiarity with industry standards such as GDPR, HIPAA, SOX, or PCI-DSS. - Proficiency in Microsoft products, especially Excel. - Demonstrate proficiency in IT systems and infrastructures, including infrastructure technologies and architectures, virtualization, cloud computing, database management, application development, data governance, and access management. - Understand cybersecurity principles and practices. - Able to analyze and interpret complex data and systems. - Exhibit excellent communication and interpersonal skills. - Able to work independently as well as with a team. - Demonstrate a strong work ethic and initiative. - Have strong attention to detail and prioritization skills. Requirements - Professional certifications such as Certified Information Systems Auditor (CISA), Certified Internal Auditor (CIA), Certified Information Security Manager (CISM) or Certified Information Systems Security Professional (CISSP), or technical certifications. - Familiarity with IT governance frameworks like COBIT, ISO 27001, or NIST. - Candidate location in Central or Eastern US time zone is preferred. Benefits - Medical, Dental, and Vision insurance. - Performance-based bonus or sales incentive. - 401(k) retirement plan with company match. - Short-term & long-term disability insurance. - Paid time off and 10 corporate holidays. - Paid parental leave. - Company-paid life insurance. - Mental & Financial Well-Being resources.
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