Auditor Remote Jobs in Oklahoma (US)
This page tracks remote auditor openings that are location-eligible for Oklahoma.
This page tracks remote auditor openings that are location-eligible for Oklahoma.
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991 Jobs
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Molina Healthcare is a Fortune 500 managed care company with a storied history that dates back to 1980 and the opening of a medical clinic by Dr. C. David Molina. As an employer, M
Role Description Provides support for compliance auditing activities. Responsible for evaluating Molina's adherence to regulatory requirements, internal policies, and health care industry standards by identifying compliance gaps and recommending improvements to mitigate risk related to fraudulent or abusive practices. - Performs on-going compliance audits utilizing as necessary, state evaluation tools relating to audit/monitoring activities. - Identifies and defines audit scope and criteria, reviews and analyzes evidence, and documents audit finds, including making recommendations for improvement and correction where identified. - Provides comprehensive advice to assigned departments regarding compliance risks with respect to federal and state regulations and contract provisions. - Provides input and support during the annual risk assessment and audit planning processes. - Assists with monitoring activities involving the effective execution of corrective action requirements imposed by state or federal regulatory agencies for contract deficiencies. Qualifications - At least 2 years experience in audit and/or compliance, or equivalent combination of relevant education and experience. - Knowledge of relevant regulatory frameworks and compliance standards. - Understanding of internal control concepts and risk assessment methodologies. - Strong analytical and problem-solving abilities. - Attention to detail, and ability to manage multiple projects simultaneously. - Effective verbal and written communication skills. - Microsoft Office suite and applicable software program(s) proficiency. Requirements - Experience in the health care industry (preferred). Benefits - Molina Healthcare offers a competitive benefits and compensation package. Company Description Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
• Lead IT SOX program from scoping through reporting, serving as the primary contact for testing execution, timeline, and external auditor coordination. • Perform automated and IT general controls testing in support of the SOX compliance program • Collaborate with functional teams to evaluate current and new processes, advise management on control design, and identify risks and improvement areas • Partner with Compliance to ensure IT SOX documentation, including flowcharts, narratives, and controls are up to date, accurate and properly handled as part of process redesigns and system implementation efforts • Develop and maintain audit workpapers and documentation, including audit plans, testing procedures, and results • Conduct interviews and walkthrough meetings of internal stakeholders • Prepare internal audit reports and communicate results and recommendations to internal stakeholders • Monitor the remediation of identified control deficiencies and track progress towards remediation objectives • Provide clear and concise updates to your lead on the status of assignments
At Lucet, we are industry leaders in behavioral health, dedicated to helping people live healthy, balanced lives. Our purpose is to advocate for and improve the overall well-being of those we serve, through balanced treatment of the mind and body. As part of the Lucet team, employees join a mission-driven organization committed to making a lasting impact. Whether through behavioral health navigation, in-home medical care, or 24/7 crisis support, our work is rooted in empathy, collaboration, and a shared passion for helping people thrive.
Role Description The Medical Coding Auditor performs concurrent and retrospective medical coding audits to ensure coding accuracy, regulatory compliance, reimbursement integrity, and documentation quality while providing actionable feedback and collaborating with stakeholders to drive continuous improvement in coding practices and audit outcomes. Coding Audit, Accuracy & Compliance - Conduct concurrent and retrospective chart audits to validate coding accuracy, completeness, specificity, and adherence to coding guidelines and regulatory requirements. - Identify coding errors, compliance risks, and potential fraud, waste, or abuse concerns while maintaining coding integrity and supporting appropriate reimbursement. Quality Improvement & Operational Performance - Analyze audit trends, root causes, and error patterns; document findings and utilize reporting tools to support data-driven decision making. - Lead and support quality improvement initiatives by recommending workflow, process, training, and policy enhancements to improve coding quality and consistency. Stakeholder Collaboration & Education - Communicate audit findings effectively and provide constructive coaching and education to coders and internal partners. - Collaborate with coding leadership, educators, and operational teams to maintain audit consistency, support calibration efforts, and ensure adherence to organizational and regulatory standards. Qualifications - 2+ years of experience in medical chart auditing/quality in the healthcare field. - In good standing with either AAPC and/or AHIMA and hold an active CPC, CRC, CCS, CPC-P, CCS-P or PCS with a high degree of competence in this area. - Advanced proficiency in coding guidelines and regulations. - Experience in review/audit of medical records coding and development of process improvement plans. - Advanced knowledge of medical terminology, abbreviations, anatomy and physiology, major disease processes, and pharmacology. - Strong working knowledge of ICD-10-CM/PCS coding guidelines. - Ability to pass background check upon hire and throughout employment. Requirements - Ability to problem solve with the ability to encourage others in collaborative problem solving. - Excellent analytical, written and verbal communication skills, organizational, time management. Benefits - Hourly compensation between $30.80 - $35.00, PLUS an annual performance-based, discretionary incentive. - Comprehensive health benefit options: Medical, dental, and vision coverage. - 401(k) with competitive employer match. - Company-paid life and disability insurance. - Paid parental leave and wellbeing incentives. - Generous paid time off, including volunteer time. - Flexible spending accounts for healthcare and dependent care. - Professional development opportunities and tuition reimbursement. - Remote work flexibility (role-dependent). - Opportunity for meaningful growth, both personally and professionally.
Role Description Labcorp is seeking a remote Senior Clinical Data Risk & Solutions Analyst (Global Monitor) to join our team! Work Schedule: Monday – Friday, day shift Job Responsibilities - Accountable for the monitoring and reporting of clinical study laboratory metrics on a monthly and ad hoc basis. - Extract, analyze, and interpret data from multiple sources, transforming raw data into meaningful, actionable insights; present findings to key stakeholders, including the Global Study Manager, Study Design Lead, and external clients. - Conduct risk assessments in collaboration with the Global Study Manager and Study Design Lead prior to study initiation; develop and propose monitoring solutions to mitigate identified risks. - Utilize analytics and data visualization tools to proactively review study laboratory data, identify trends or issues, and ensure timely risk mitigation. - Maintain regular and effective communication with internal stakeholders to ensure alignment and study success. - Engage with external clients as needed, including presenting monitoring plans during bid defenses and throughout the study lifecycle. - Contribute to organizational growth through participation in continuous improvement initiatives and process optimization within Labcorp. - Provide mentorship and guidance to newly hired Global Monitors. - Operate effectively in a fast-paced environment with shifting timelines and priorities. - Participate in and present at functional meetings (e.g., Labcorp Learning Forums), providing input to enhance and maintain current processes. - Ensure compliance with CCLS Global Project Management strategies and standards. - Promote and support a culture of continuous improvement, quality, and productivity. - Perform additional duties as assigned. Qualifications - Bachelor degree in science - 5 or more years’ experience monitoring clinical trials data and/or reporting metrics Requirements - Master’s degree in science (preferred) - 3 or more years of experience in Excel (preferred) - 1 or more years of experience in client management (preferred) - Advanced proficiency in Excel (including working knowledge of Power Query) - Experience creating complex study addendums independently with high quality and minimal revisions - Ability to perform study monitoring and deliver insightful, value‑added analysis in clear, client‑friendly communications - Strong capability to independently conduct risk assessments and provide actionable recommendations - Accurate and consistent data entry and workload tracking (e.g., Workfront) - Proven mentorship skills, with the ability to develop new hires to work with minimal supervision - Analytical, data-driven mindset with a natural curiosity - Strong problem-solving and critical thinking skills - High attention to detail and commitment to quality standards - Ability to manage multiple priorities and work effectively in a fast-paced environment - Strong communication skills, with the ability to clearly convey ideas and influence outcomes - Self-motivated with a commitment to continuous learning and improvement - Customer-focused with strong stakeholder management skills - Proficiency in data visualization and analytics tools (e.g., Spotfire, Tableau, R) Benefits - Comprehensive benefits including: Medical, Dental, Vision, Life, STD/LTD, 401(k), Paid Time Off (PTO) or Flexible Time Off (FTO), Tuition Reimbursement and Employee Stock Purchase Plan for employees regularly scheduled to work 20 or more hours per week. - Employees regularly scheduled to work less than 20 hours, Casual, Intern, and Temporary employees are only eligible to participate in the 401(k) Plan. Application Window June 25, 2026 – June 30, 2026 Pay Range $90,000 - $110,000
• Review medical records and clinical documentation to ensure accurate, complete, and compliant coding in accordance with CMS regulations, federal and state guidelines (e.g., AHIMA, CMS, Medicaid), and payer-specific policies. • Conduct routine and focused coding audits to identify documentation gaps, coding discrepancies, and areas of compliance risk. • Collaborate with clinical leadership, revenue cycle, and compliance teams to resolve coding discrepancies and support accurate documentation practices. • Communicate audit findings to providers and coding staff, providing actionable, audit-defensible recommendations and targeted education. • Perform follow-up audits to validate remediation efforts and ensure sustained improvements in coding accuracy and compliance. • Prepare written reports of findings to Compliance Leadership on charts reviewed per quarter, coding accuracy metrics, and identified risk areas. • Serve as a subject matter expert on pediatric, Medicaid, telehealth, and behavioral health coding, providing guidance on complex or high-risk scenarios. • Interpret and apply state-specific Medicaid and payer billing requirements, maintain expertise across multiple markets and ensure alignment with regulatory and contractual guidelines; continuously research, monitor, and educate providers and coding staff on emerging payer policies, state expansions, and industry changes.
Cohere Health is a Software-as-a-Service (SaaS) company focused on improving the patient journey by enhancing the quality of care at lower costs, as well as emp
Role Description We are seeking a Senior DRG Auditor, Disputes to join our dynamic Payment Integrity team. This critical role involves conducting comprehensive MS-DRG and APR-DRG coding reviews to ensure the accuracy of claims and maximize overpayment identification. If you possess a CCS credential, superior knowledge of ICD-10-CM/PCS coding guidelines, and a passion for deep analytical work, you will be instrumental in supporting Cohere Health’s commitment to accurate reimbursement solutions. This opportunity requires a self-motivated individual who thrives on precision, compliance, and continuous learning in a high-growth environment. - Conduct comprehensive MS-DRG and APR-DRG coding reviews to ensure accuracy in DRG assignment and reimbursement. - Apply expert knowledge of coding guidelines and utilize industry-leading tools to maximize overpayment identifications. - Craft clear, concise, and well-supported audit findings, backed by AHA Coding Clinic Guidelines and ICD-10-CM/PCS regulations. - Utilize advanced DRG encoder tools to drive efficiency and accuracy in audits. - Meet or exceed company quality and productivity standards, including strong uphold rates for appeals. - Stay ahead of industry trends, coding updates, and compliance regulations to maintain expert-level knowledge. - Adhere to HIPAA and company policies and procedures to ensure data security and regulatory compliance. - Maintain and apply superior knowledge of changes and updates to coding guidelines, reimbursement trends, and health payment policy language. Qualifications - 6+ years experience of performing MS-DRG and ARP-DRG reviews for a Payment Integrity vendor or Payer required. - Experience with provider appeals/dispute reviews required. - Requires advanced expertise in ICD-10-CM/PCS coding and the ability to exercise discretion and professional judgment in assessing complex clinical information, validating diagnosis code assignments, and identifying discrepancies such as coding errors or upcoding. - Prepares clear, concise, and well-supported audit findings, referencing authoritative sources such as AHA Coding Clinic and ICD-10 guidelines, ensuring recommendations reflect professional expertise. - An active certified coder credential (e.g., CIC, CPC, CCS, RHIA, or RHIT) required. - CCS (Certified Coding Specialist) credential highly preferred. - Self-motivated and able to work independently in a remote environment while maintaining high performance. - Consistently meets or exceeds established quality and productivity standards while managing priorities and workflow autonomously. - Passion for DRG auditing and a commitment to teamwork, collaboration, and continuous learning. - Excellent written and verbal communication skills, strong analytical skills, and attention to detail. - RHIA, or RHIT credential, Associate's Degree in Health Information Management, Nursing, or related field preferred. - Inpatient audits for case rate and per diem. - Experience working in a start-up or high-growth company environment, demonstrating agility and adaptability. - Familiarity with working with a diverse, global team of talent. - Excellent computer skills and familiarity with a Mac. - Payment Integrity audit experience preferred. Benefits - Fully remote opportunity with about 5% travel - Medical, dental, vision, life, disability insurance, and Employee Assistance Program - 401K retirement plan with company match; flexible spending and health savings account - Flex Time Off + company holidays - Up to 14 weeks of paid parental leave - Pet insurance Interview Process - Connect with Talent Acquisition for a Preliminary Phone Screening - Meet your Hiring Manager! - Case Study - Interview with Subject Matter Expert - Behavioral Interview(s)
Role Description In this position... - Our Global Dealer Engagement team builds successful partnerships with our 9,500 dealers. - Helps dealers unlock their full potential and increase customer satisfaction. - Focuses on training and productivity, governance, customer sentiment, diversity, community, retail excellence, systems and process modernization, and rewards and recognition. - Aims to help dealers differentiate themselves from the competition and maximize their strengths. Qualifications - Marketing, sales, and service expertise. - Ability to turn data-driven insights into innovative solutions. - Experience enhancing sales and customer loyalty. Requirements - Strong partnership-building skills. - Experience in training and productivity improvement. - Knowledge of governance and customer sentiment analysis. Benefits - Opportunity to work with a visionary vehicle and mobility services company. - Chance to make a significant impact on customer experience.
We make sense of data to drive your business forward. #MakeSenseofData #DriveYourBusinessForward #PartnerYourWay
Role Description We’re looking for a Behavioral Health Auditor III to join us in a fully remote role. In this position, you’ll use your knowledge of payer policies, industry standards, and regulatory guidelines to review and audit Behavioral Health claims. Your work will directly impact the integrity of healthcare payments and help ensure accurate, compliant practices across the industry. This isn’t just auditing—it’s about bringing insight, spotting trends, and helping shape the future of Behavioral Health payment integrity. - Salary Range: $60,100 - $85,800* - Location: 100% Remote (U.S.-based) - Up to 10% annual travel (for team meetings and limited client onsite engagements.) Benefits For more information on benefits and what we offer please visit us at EXL Careers and Benefits . 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. EXL harnesses the power of data, analytics, AI, and deep industry knowledge to transform operations for the world’s leading corporations in industries including: - Insurance - Healthcare - Banking and financial services - Media - Retail EXL was founded in 1999 with the core values of innovation, collaboration, excellence, integrity and 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. EXL is the indispensable partner for leading businesses in data-led industries such as: - Insurance - Banking and financial services - Healthcare - Retail - Logistics We bring a unique combination of data, advanced analytics, digital technology and industry expertise to help our clients turn data into insights, streamline operations, improve customer experience, and transform their business. Our partnerships with clients are built on a foundation of collaboration – and we’ve been chosen as a partner by nine of the top ten leading US insurance companies, nine of the top 20 global banks, and six of the top ten US health care payers. Clients choose EXL as their transformation partner for many reasons: - Our geographic diversity makes talent all over the world instantly accessible. - Digital accelerators enable unmatched speed-to-value, letting you realize results fast. - It’s our people that truly set us apart, including the 1,500 data scientists we have dedicated to our generative AI practice. - More than twenty years of experience in delivering business services, garnering stellar client references, and maintaining 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.
Since our start in 2006, our dedicated teams strive daily to ensure that each and every customer is treated like family!
• Review all leads submitted by the Field Marketing team each Saturday and Sunday morning • Verify lead accuracy and completeness within Salesforce across MIC and Costco retail channels • Identify and flag duplicate, incomplete, or inaccurate lead entries for correction • Ensure all required lead fields are properly populated (name, address, phone, appointment details, product interest, etc.) • Cross-reference submitted leads against event sign-in sheets, demo logs, or supporting documentation as available • Compile a weekend lead quality summary report for the Field Marketing Director upon completion of each shift • Document and communicate all lead discrepancies, errors, or patterns observed to the FMM in a timely manner • Provide actionable feedback to support coaching and accountability for field team members • Navigate and audit lead records within Salesforce CRM with proficiency • Ensure Salesforce data hygiene standards are maintained across MIC and Costco lead sources • Flag systemic entry issues and assist in identifying training gaps related to lead submission quality
UPMC Health Plan is a rapidly growing health insurance company based in Pittsburgh, Pennsylvania. Owned by the award-winning University of Pittsburgh Medical Ce
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
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