Medical Audit Jobs

Oscar Health is hiring a Senior Specialist, Risk Adjustment to conduct ICD-10-CM coding and medical record reviews across MA and ACA lines while supporting CMS audit readiness and process improvements.

Lead and optimize offshore post-visit coding operations for CenterWell/Humana by driving quality assurance, vendor collaboration, and continuous improvement across coding teams.

Datavant is hiring an experienced HCC Risk Adjustment Coding Auditing Team Lead to oversee auditor quality, mentor coders, and maintain high accuracy in a fully remote role.

Experienced coding leader sought to lead remote Florida-based medical coding teams, driving risk-adjustment strategy, coding quality, and GenAI-enabled productivity across markets.

Integrated Dermatology is hiring a Senior Accountant to manage monthly financial reporting, analyses, and accounting operations for multiple medical practices in a fully remote role.

Medtronic Minimed Americas is hiring a Regional Distribution Quality Specialist to drive distribution quality, regulatory compliance and continuous improvement across 3PL sites in the Americas.

AbbVie seeks a Documentation Specialist with strong EDMS and change-control experience to manage controlled documents, support audits, and lead change-control activities at the Branchburg site.

Experienced quality professional needed to lead CAPA and NC investigations remotely for a regulated US-focused organization, ensuring compliance and continuous improvement.

Presbyterian seeks an experienced SIU Field Investigator to perform medium- to high-complexity onsite provider audits and investigations across New Mexico to detect and resolve healthcare fraud, waste, and abuse.

Presbyterian Healthcare Services seeks a Hybrid Remote RN Nurse Auditor to perform clinical validation and HCC coding support for Medicare Risk Adjustment across PMG and AHWA clinics.

Humana is hiring a Nurse Audit Manager to lead audit and validation of clinical documentation and coding, ensuring compliance and accurate reimbursement across a remote nationwide team.

A board-certified physician with DRG audit expertise is sought to deliver rigorous clinical reviews and directly inform the development of Machinify's AI-powered DRG adjudication platform.

Oscar is seeking a Senior Analyst on the Payment Integrity team to drive claims process improvements, investigate payment edits, and translate findings into prioritized business requirements.

An experienced ISO 13485 Lead Auditor is needed to perform MDSAP and 21 CFR Part 820 audits, lead client engagements, and mentor audit teams for a growing MedTech CRO.

The Administration for Children’s Services is hiring a New Admissions Nurse Reviewer to conduct medical audits, evaluate compliance with health standards, and support quality monitoring for foster care youth across NYC.

UMMS is hiring a detail-oriented Coding Compliance Auditor to perform inpatient and outpatient coding audits, support coding quality initiatives, and provide guidance and training across hospital coding teams.

Centene seeks a meticulous Claims Quality Auditor to perform pre- and post-payment claim audits, identify payment errors, and drive corrective actions for a large, nationally diversified health plan.

University of Rochester Patient Financial Services is hiring a Claims Resolution Representative IV to resolve complex insurance claims, maximize revenue collection, and train staff.

UChicago Medicine is hiring a Revenue Integrity Specialist to lead coding, billing audits, denials reduction, and revenue cycle improvements for clinical lab services in a primarily remote, hybrid role.

Experienced pharmacovigilance operations leader wanted to manage and develop Support Operations teams, ensuring efficient case initiation, data entry and documentation in support of drug safety and regulatory compliance.

Lead remote risk-adjustment coding operations as the Client Coding Project Manager, overseeing QA, audits, vendor management, and process improvement to ensure coding accuracy and compliance.

Lead a remote cardiology coding team at Advocate Health, applying advanced ICD-10/CPT expertise to ensure accurate reimbursement, compliance, and continuous quality improvement.

Join Dandy as a Quality Systems Specialist to maintain audit-ready QMS practices, support eQMS rollout, and ensure regulatory compliance across multi-site medical device operations.

University of Maryland Medical System is hiring an Outpatient Coder to accurately assign ICD-10 and CPT codes for ED and outpatient visits to support reimbursement and compliance.

AbbVie is seeking an Associate Director to lead quality assurance for Medical Affairs and RWE activities, ensuring regulatory compliance and driving quality strategies across drug, device, and cosmetic portfolios.

Experienced medical device quality engineer wanted to lead CAPA, audits, and QMS improvements for a plastic medical device manufacturer operating under FDA and ISO requirements.

DaVita seeks a Revenue Specialist I for the ONEReg team to research eligibility/payor issues, resolve discrepancies, audit alerts, and help optimize revenue workflows.

Experienced coding and compliance leader needed to manage program integrity auditing, vendor/product implementations, and reimbursement review for a health plan-focused team.

Join DCH Health System as an on-site HIM Data Integrity Specialist responsible for MPI maintenance, Expanse merges/unmerges, and ensuring accurate patient records across systems.

Experienced medical coder and investigator needed to lead coding reviews and fraud investigations for a major nonprofit healthcare system.

Lead the design and operation of OrganOx's QMS and document services, driving eQMS excellence, compliance, and a high-performing global team.