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Role Description Our internal audit activities determine whether the organization’s risk management, control, and governance processes are adequate and functioning. We strive not only to ensure that the company’s mission, goals, strategies, policies, and procedures are coherent and that risks are promptly identified and managed, thus helping to achieve objectives, but also to ensure that the use of company resources is maximized and that assets are safeguarded. The job will be assigned to the Audit & Compliance department/Financial services organization. Audit Areas of scope: - Retail Lending (originating loans for new or used vehicles) - Retail Leasing (end customer vehicle leasing) - Wholesale Lending (commercial financing, including floor plan funding, to dealerships) - Factoring and other financial processes (Securitization, Deposit, Asset-backed…) - White Labels agreements with external banks Covered geographical scope: Global role with audits completed mostly remote. Qualifications - Bachelor’s degree from an accredited college/university with a relevant business discipline essential or equivalent work experience - Economics, Management University Degree or related business field - A minimum of eight years’ experience working in captive financial services and/or banking, or in an area relevant to the assigned responsibilities - Knowledge of banks, financial services, Insurance business, its operations, procedures, and policies, including the general understanding of the related laws and regulations - Proven Data Analytics knowledge and applied use of Artificial Intelligence - Fluent in advanced English (both oral and written); a second language is preferred (French, Portuguese, Spanish, German) - Internal Audit international certifications (e.g., CIA, CISO, CRMA, CFE) are a plus - Strong interpersonal skills and team-work ability, proactive attitude, result oriented - Attention to detail and a commitment to maintaining accurate and up-to-date records and documentation - Technical writing - Competency with Microsoft Applications (Word, Excel, Access, Power Point) is required; knowledge of accounting systems (SAP) would be appreciated - Availability for international travel (up to 10% of the time) Requirements - Deliver internal audit services as part of an audit team, conducting audit assignments as Lead auditor, including: - Planning of the audit activity and walkthrough - Develop audit work program - Perform Interviews, tests, sample review, communication with multiple departments, assess internal control system for design effectiveness and operational effectiveness - Ability to evaluate and conclude on the Internal Control System - Prepare audit reports and the related working papers which effectively communicate the audit results, making necessary revisions in a timely manner - Assist in the follow up implementation of management actions plans, as a result of audits - Assist in the development of overall risk assessment of the company and annual audit plan preparation - Work independently and in a team environment - Maintain a harmonious and cooperative relationship with the auditees having an impartial and unbiased attitude - Interact with different hierarchical levels of the organization - Participate in special, audit and non-audit projects, as needed
• Generate and Develop New Audit Concepts - Utilizes retail and auditing experience to perform audit procedures that include analyzing, identifying and defining issues, developing criteria, reviewing and analyzing evidence with the intent to audit standard medium - complex reports. • Leader in concept development across multiple audit verticals. • Develops New Tools and Processes - Collaborates with Business Optimization and audit team in developing new tools and reports. • Direct Ownership for Quality Control - Reviews all level auditor claims prior to and after client submission. • Prepare Response to Client Disputes - Provide oversight to audit team for verification of claims validation in concise written or oral manner. • Review Client Transactions - Demonstrates high level of expertise in reviewing transaction types, client contracts/vendor agreements, and client data with minimal supervision of how to identify potential over/under payments. • Participate in knowledge sharing with audit, region, & division.
Role Description Are you ready to bring your clinical competencies to a world-class Medical Group known for the very highest clinical standards? Do you have a passion for the highest quality and patient satisfaction? Then please respond to this dynamic opportunity available with one of the best places to work in Southern California! The Claims Auditor is responsible for ensuring the accuracy of claims processing based on department policies and procedures, CMS and DMHC regulations. Primary Duties and Responsibilities - Conducts detailed audits for compliance with State, Federal and Health Plan regulatory requirements. - Conducts pre and post payment audits on adjudicated claims in compliance with Cedar-Sinai policies, procedures and payment methodologies. - Documents audit findings and presents errors to Claims Operations for corrections, root cause analysis and appropriate resolution. - Provides analysis and prepares recommendations to Management for errors and inconsistencies. - Provides process improvement suggestions to Management. - Monitors appeals from providers, members and health plans to make sure they are processed accurately and in a timely manner. - Monitors the daily auditing of processed claims and letters for accuracy. - Distributes and monitors multiple projects to make sure deadlines are met. Benefits - Outstanding benefits. - Competitive salaries. - Health and dental insurance. Company Description Cedars-Sinai is a leader in providing high-quality healthcare encompassing primary care, specialized medicine and research. Since 1902, Cedars-Sinai has evolved to meet the needs of one of the most diverse regions in the nation, setting standards in quality and innovative patient care, research, teaching and community service. Today, Cedars-Sinai is known for its national leadership in transforming healthcare for the benefit of patients. Cedars-Sinai impacts the future of healthcare by developing new approaches to treatment and educating tomorrow's health professionals. Additionally, Cedars-Sinai demonstrates a commitment to the community through programs that improve the health of its most vulnerable residents. With a growing number of primary urgent and specialty care locations across Southern California, Cedars-Sinai’s medical network serves people near where they live, delivering coordinated, compassionate healthcare.
Builders FirstSource is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status or status as an individual with a disability.
Role Description Evaluates wood commodities pricing and suppliers and purchases lumber to meet company’s goals in quality, delivery and cost, negotiating primarily with mills, brokers, and wholesalers to obtain competitive costs. Maintains on-going relationships with suppliers by securing bids and placing purchase orders. Replenishes distribution center lumber inventory as needed. - Analyzes wood and panel commodities prices in current cash and futures markets to enable acquisition of products at optimum cost. - Interviews key wood and or panel commodity sources to obtain information about short and long term market prices. - Purchases wood commodities and places special orders with consideration as to cost and market timing. - Develops market information and advises supply chain personnel as to current pricing, market trends, availability, freight information, order status, and product location. - Solicits, analyzes, and recommends vendor products and programs for wood and panel merchandise such as dimension lumber, OSB, and plywood. - Processes claims/complaints regarding defective merchandise. - Prepares and maintains appropriate records of purchases and freight by use of purchase order and filing system. - Places special orders as requested. - Communicates market fluctuations and any related commodities problems. - Provides training and guidance to less experienced buyers. - Other duties may be assigned. Qualifications - Bachelor’s degree in Supply Chain Management or related field. - Eight (8) years related experience. - Or an equivalent combination of education and experience. - Experience using JDA helpful or other ERP statistical software packages. Requirements - Comprehensive knowledge of material management and procurement function. - Skill in analyzing market trends. - Strong analytical, quantitative, problem solving, and technical skills. - Ability to plan, organize, and manage multiple tasks simultaneously. - Knowledge of market and business and commodity management. - Excellent oral and written communication skills. - Excellent negotiation skills. - Strong organizational and time management skills. - Exhibit proficiency in Microsoft Office Suite and an enterprise resource planning (ERP) program. Benefits - Medical, dental, vision, and disability insurance plans. - 401(k) retirement savings plan. - PTO (including paid sick time). - 8 paid holidays per year (for salaried and hourly team members).
Builders FirstSource is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status or status as an individual with a disability.
Role Description The Buyer uses a strategic approach to sourcing materials, negotiating, purchase order management, managing supplier relationships, and collaboration with internal departments to ensure the timely delivery of quality products at competitive prices. By effectively balancing cost, quality, and supply chain risks, the Buyer supports the organization’s overall efficiency and profitability, ensuring that the production schedules and project demands are met with precision. Essential Duties and Responsibilities - Procurement & Replenishment Transactions Execution - Manage purchase orders from placement through delivery, ensuring timely receipt of materials. - Implement and maintain procurement policies and procedures to ensure compliance with company standards and industry’s best practices. - Evaluate Field purchase requests, source based on business needs, ensuring cost, quality, and delivery standards are met. - Negotiate and purchase spot buys, and coordinate with vendors for product details, pricing, lead times, and delivery schedules. - Supplier Coordination & Relationship Management - Develop and maintain positive relationships with suppliers and stakeholders. - Work closely with preferred suppliers to expedite purchase order deliveries, confirm order details, and address supply issues through constant communication. - Coordinate potential re-routing of delivery from one site to another based on Field requests. - Inventory Level Optimization - Monitor inventory levels and coordinate with operations to ensure the availability of required materials. - Assist with location inventory management by tracking stock levels and demand fluctuations. - Report potential inventory adjustment needs to the Supply Planner, Inventory Manager, and Director / Category Manager. - Issue Resolution & Stakeholder Communication - Address and resolve procurement process issues, collaborating with relevant stakeholders. - Ensure clear, concise, and timely communication with internal and external stakeholders regarding procurement activities. - If unable to resolve, escalate procurement risks or issues to the Purchasing Manager, providing potential mitigation or remediation plans for review. - Data & Compliance Management - Maintain accurate records throughout the procure-to-pay (P2P) process to ensure traceability and transparency for audits and reviews. - Ensure all procurement activities comply with company policies and industry regulations. - Continuous Improvement - Identify continuous improvement, automation, simplification, and streamlining of the processes and transactions execution and discuss them with the Purchasing Manager or a Senior Buyer. Qualifications - Bachelor’s degree in supply chain or a related field. - 1-3 years of purchasing experience; or equivalent combination of education and experience. - Prior experience in the lumber or millwork industry is strongly preferred. Requirements - Competencies listed are non-exhaustive but meant to be illustrative of the fundamental skillsets required to perform the duties and responsibilities listed above. - Key Functional Skills - SAP Proficiency - Practicing - Attention to Detail (PO Accuracy) - Mature - Product & Market Trends - Practicing - Industry Intelligence - Knowledge - Key Behavioral Skills - Verbal & Written Communication - Practicing - Adaptability - Practicing - Cross-Functional Collaboration - Practicing - Key Leadership Skills - Client Service Attitude - Mature Benefits - Medical, dental, vision, and disability insurance plans. - 401(k) retirement savings plan. - PTO (including paid sick time). - 8 paid holidays per year (for salaried and hourly team members).
Award-winning recruitment consultancy; delivering talent across Tech, Digital, Life-Sciences, Energy & Construction
• Responsible for daily operations pertaining to Risk Adjustment including but not limited to: medical record reviews to report ICD-10-CM diagnosis codes for ACA and MA lines of business, potential Centers of Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record retrieval efforts. • Mitigate risk by validating Encounter Data Gathering Environment Server (EDGE) data is supported within provider encounter documentation • Review the performance of the Risk Adjustment Coding team and report audit trends to Leadership in a timely, consistent and effective manner to ensure the appropriate changes and education are implemented. • Maintain compliance with national standards and coding practices set by the ICD-10-CM coding guidelines for accuracy, as well as compliance with Risk adjustment production standards. • Conduct CMS audits of Risk Adjustment activities, including but not limited to Risk Adjustment Data Validation audits. • Develop relationships with key individuals to foster an increased understanding of the Risk Adjustment process. • Identify and execute on the creation of clinical document improvement resources for provider education in both MA and ACA line of business. • Manage the implementation process improvements that will maximize risk adjustment factor increases. • Compliance with all applicable laws and regulations • Other duties as assigned
Operating on the belief that healthcare is broken, Oscar Health Insurance is on a mission to reinvent and humanize the industry by combining technology, design,
Role Description The Associate, Risk Adjustment Auditor conducts internal and external quality audits. Quality audits are specific to ICD-10 code abstraction relative to accuracy, completeness, and identified clinical documentation improvement opportunities. The Associate, Risk Adjustment Auditor works with management to implement benchmarks, establish acceptable thresholds, and quality assurance programs. You will report into the Manager, Risk Adjustment. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote Pay Transparency: The base pay for this role is: $82,717 - $108,566 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities - Responsible for daily operations pertaining to Risk Adjustment including but not limited to: medical record reviews to report ICD-10-CM diagnosis codes for ACA and MA lines of business, potential Centers of Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record retrieval efforts. - Mitigate risk by validating Encounter Data Gathering Environment Server (EDGE) data is supported within provider encounter documentation. - Review the performance of the Risk Adjustment Coding team and report audit trends to Leadership in a timely, consistent and effective manner to ensure the appropriate changes and education are implemented. - Maintain compliance with national standards and coding practices set by the ICD-10-CM coding guidelines for accuracy, as well as compliance with Risk adjustment production standards. - Conduct CMS audits of Risk Adjustment activities, including but not limited to Risk Adjustment Data Validation audits. - Develop relationships with key individuals to foster an increased understanding of the Risk Adjustment process. - Identify and execute on the creation of clinical document improvement resources for provider education in both MA and ACA line of business. - Manage the implementation process improvements that will maximize risk adjustment factor increases. - Compliance with all applicable laws and regulations. - Other duties as assigned. Qualifications - Bachelor's degree in a relevant field of study or commensurate work experience. - Certified professional coder (CPC). - 3+ year(s) retrospective risk adjustment coding experience. - 1+ year(s) experience Quality Auditing and/or Risk Adjustment Data Validation Audit (RADV) experience. Bonus Points - Certified Risk Adjustment Coder (CRC) or similar certification. - Experience coding in a variety of different Electronic Medical Record (EMR) systems. Benefits - Medical, dental, and vision benefits. - 11 paid holidays. - Paid sick time. - Paid parental leave. - 401(k) plan participation. - Life and disability insurance. - Paid wellness time and reimbursements. Company Description At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.
Founded in 1894, UL Solutions is self-described as a global leader in applied safety science and provides high-quality product safety evaluations. For over a century, the company h
Role Description Lead Auditor - GMP Quality Audits will perform high level assessments of quality systems in a variety of manufacturing sites, farms, processing plants and/or other work related sites throughout a region or country. - Assess and report in accordance with UL, industry scheme, and client audit protocols on facilities working and/or operational conditions as it relates to established industry standard(s) for GMP, Quality Systems, Food Safety initiatives and/or client programs. - Maintain a high level of technical knowledge and play an active mentoring role with trainees, auditors and lead auditors in the field. - Participate and lead higher level audits; involving complex methodologies, advanced analysis, and comprehensive/intricate reporting. Reports will be written in English in an objective, accurate, detailed and timely manner. - Specific Regulatory Standard(s) Competency are a focus including: - OTC Drug/Pharmaceuticals: 21CFR211/210 - Nutritional Supplements: 21CFR111 - Medical/Homecare Devices: 21CFR820 - Cosmetics: ISO22716 - Complete audit agendas within 14 calendar days of the audit. - Complete reports within 4 calendar days of the audit. - Submit audit expenses in a timely manner. - Complete at least 10 days of audits per month minimum capacity. Company Description A global leader in applied safety science, UL Solutions (NYSE: ULS) transforms safety, security and sustainability challenges into opportunities for customers in more than 110 countries. - UL Solutions delivers testing, inspection and certification services, together with software products and advisory offerings, that support our customers’ product innovation and business growth. - The UL Mark serves as a recognized symbol of trust in our customers’ products and reflects an unwavering commitment to advancing our safety mission. - We help our customers innovate, launch new products and services, navigate global markets and complex supply chains, and grow sustainably and responsibly into the future. - Our science is your advantage. - From life jackets to lawnmowers, toys to televisions, beauty and wellness, vitamins and supplements, we’re involved in almost every consumer product you can imagine. - We work with some of the largest retailers in the world, performing market surveillance, auditing and inspecting the products we put in and on our bodies. - We help customers ensure that not only are their products themselves safe, but their supply chains are using ethically and sustainably sourced materials. - We build close relationships, providing advice and expertise to help them deliver safer products that meet the latest requirements and manufacture them fairly. - Join our team and make your mark on products that shape people’s lives.
Role Description The Medical Records Technician (Coder-Auditor) serves as an expert in current coding conventions and guidelines related to professional and facility coding. Auditors perform audits of encounters to identify areas of noncompliance in coding. - Work Schedule: 8:00am to 4:30pm, Monday-Friday - Compressed/Flexible: Not Authorized - Remote: These approved positions are currently designated for a mid-term extension to the return to office mandate through October 2025. While these positions may be filled as remote, the employee will be required to return to the office if the mid-term extension is not continued. Therefore, all applicants must be located within 50 miles of a VA facility. - Telework: Once returned to the office, Telework may be approved as ADHOC, depending on Supervisor approval. - Virtual: This is not a virtual position. - Functional Statement #: 10444-F - Relocation/Recruitment Incentives: Not Authorized - Permanent Change of Station (PCS): Not Authorized - PCS Appraised Value Offer (AVO): Not Authorized Major Duties include but are not limited to the following: - Reviews coding and assists coders in improving coding accuracy; provides coding guidance to various levels of staff to promote consistency in practice and compliance with coding rules and regulations; initiates various reports and analyzes data. - Monitors ever-changing regulatory and policy requirements affecting coded information for the full spectrum of services provided by the VAMC. - Reviews assigned codes from the current version of several coding systems to include current versions of the International Classification of Diseases (ICD), Current Procedural Terminology (CPT), and/or Healthcare Common Procedure Coding System (HCPCS). - Applies guidelines specific to certain diagnoses, procedures, and other criteria used to classify patients, under the Veterans Equitable Resource Allocation (VERA) program that categorizes all VA patients into specific classes representing their clinical conditions and resource needs. - Responsible for performing audits of coded data, developing criteria, collecting data, graphing and analyzing results, creating reports, and communicating in writing and/or in person to appropriate leadership and groups. - Audits accurate and complete assignment of ICD-10-CM, ICD-10-CPT and/or ICD-10-PCS codes, MS-DRG, POA status, and discharge disposition values for health records as assigned. Audit function includes evaluation of clinical documentation to support optimal code assignment. - Maintains statistical database(s) to track the results and validate the program for identifying patterns and variations in coding practices with regular reports to the medical staff and management. - Researches complex coding issues and participates in process improvements related to coding. - Provides training and education to coding and clinical staff to improve coding accuracy. Qualifications - Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. - Basic Requirements: - United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. - Experience and Education: - 1. Experience: One year of creditable experience that indicates knowledge of medical terminology, anatomy, physiology, pathophysiology, medical coding, and the structure and format of health records. - OR, - 2. Education: An associate's degree from an accredited college or university recognized by the U.S. Department of Education with a major field of study in health information technology/health information management, or a related degree with a minimum of 12 semester hours in health information technology/health information management (e.g., courses in medical terminology, anatomy and physiology, medical coding, and introduction to health records); - OR, - 3. Completion of an AHIMA approved coding program, or other intense coding training program of approximately one year or more that included courses in anatomy and physiology, medical terminology, basic ICD diagnostic/procedural, and basic CPT coding. The training program must have led to eligibility for coding certification/certification examination, and the sponsoring academic institution must have been accredited by a national U.S. Department of Education accreditor, or comparable international accrediting authority at the time the program was completed; - OR, - 4. Experience/Education Combination: Equivalent combinations of creditable experience and education are qualifying for meeting the basic requirements. Requirements - Certification: Persons hired or reassigned to MRT (Coder) positions in the GS-0675 series in VHA must have either: - (1) Apprentice/Associate Level Certification through AHIMA or AAPC. - (2) Mastery Level Certification through AHIMA or AAPC. - (3) Clinical Documentation Improvement Certification through AHIMA or ACDIS. - English Language Proficiency: MRTs (Coder) must be proficient in spoken and written English as required by 38 U.S.C. § 7403(f). Benefits - May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria). Grade Determinations - Medical Records Technician (Coder) Auditor, GS-9. - The MRT (Coder) Auditor assignment is a position above the journey level. - Experience: One year of creditable experience equivalent to the journey grade level of a MRT (Coder), GS-8. - Certification: Employees at this level must have a mastery level certification. - Demonstrated Knowledge, Skills, and Abilities: - Advanced knowledge of current coding classification systems such as ICD, CPT, and HCPCS for the subspecialty being assigned (outpatient, inpatient, outpatient and inpatient combined). - Ability to research and solve complex questions related to coding conventions and guidelines in an accurate and timely manner. - Ability to review coded data and supporting documentation to identify adherence to applicable standards, coding conventions and guidelines, and documentation requirements. - Ability to format and present audit results, identify trends, and provide guidance to improve accuracy. - Skill in interpersonal relations and conflict resolution to deal with individuals at all organizational levels. Physical Requirements - See VA Directive and Handbook 5019. - The full performance level of this vacancy is GS-9.
• Assess job-specific needs and develop technical training plans with clear business objectives • Select training/instructional methods and procedures appropriate for the situation • Deliver specific training sessions, including using suitable delivery methods such as classroom, online, and webinar • Identify the development needs of others and coach, mentor, or otherwise assist others with improving their knowledge skills • Provide support to the CCV audit team members; assist with orientation of new members as needed • Promote audit accuracy measures by training/educating and mentoring the auditor and providing documented and validated findings • Conduct or arrange for ongoing technical training and personal development classes for staff members • Integrate healthcare auditing principles and use objectivity in the performance of medical audit activities and reviews • Provide feedback on reviews to the Quality Assurance Manager as indicated
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