1,378 Audits jobs in the United States

Are you ready to accelerate your potential and make a real difference within life sciences, diagnostics and biotechnology?
At Aldevron, one of Danaher's ( 15+ operating companies, our work saves lives-and we're all united by a shared commitment to innovate for tangible impact.
You'll thrive in a culture of belonging where you and your unique viewpoint matter. And by harnessing Danaher's system of continuous improvement, you help turn ideas into impact - innovating at the speed of life.
At Aldevron, we deliver world-class CDMO services that accelerate the development of groundbreaking therapies. Our mission is to be the engine of innovation for genomic medicine pioneers. As a member of our team, you'll help bring life-changing innovations to life-impacting millions around the world. We bring together deep scientific expertise, an unwavering commitment to quality, and a collaborative spirit to drive progress. Whether you're launching your career or bringing years of experience, we value the unique perspective you bring. Join us and become part of a mission-driven team advancing science and unlocking human potential-one discovery at a time.
Learn about the Danaher Business System ( which makes everything possible.
The Manager of Global Audits is responsible for maintaining the internal and external audit programs in compliance to all domestic and foreign quality regulatory expectations. This position will ensure auditors have the education, experience and/or training vital to be able to identify compliance issues and find resolution in a highly autonomous manner.
This position reports to the Sr. Director of Regulatory and is part of the Regulatory and Audit department l ocated in Fargo, ND and will be onsite.
In this role, you will have the opportunity to:
+ Manage Audit Programs: Plan, execute, and oversee internal and external GMP and Quality audits. Ensure timely completion of audit reports and effective follow-up on corrective actions to maintain compliance and audit readiness.
+ Ensure Regulatory Compliance and Expertise: Maintain deep knowledge of applicable regulations and standards (e.g., 21 CFR, EudraLex, ISO, ICH, WHO). Provide expert interpretation of cGMPs and regulatory expectations to internal stakeholders.
+ Quality Oversight of Materials and Specifications: Oversee quality aspects of material onboarding, including specification development and compliance tracking, ensuring alignment with regulatory and internal quality requirements.
+ Training, Development, and Succession Planning: Lead the training, coaching, and development of auditing personnel. Maintain a robust qualification program and support succession and business continuity planning.
+ Regulatory Communication and Documentation: Draft, review, and finalize responses to regulatory authorities and clients in collaboration with senior leadership. Monitor and communicate industry trends and regulatory developments.
+ Leadership and Team Management: Provide strategic direction and mentorship to the audit team. Foster a culture of accountability, quality, and continuous improvement aligned with GxP principles.
+ Stakeholder Engagement and Collaboration: Build and maintain strong relationships with internal departments and cross-functional teams. Ensure effective communication and collaboration to support quality objectives.
The essential requirements of the job include:
+ Bachelor's degree in Life Sciences, Pharmacy, or related field
+ 5+ years of experience in Quality Assurance or Regulatory Compliance within a GMP-regulated environment with at least 2+ years in a leadership or audit management role
+ In-depth knowledge of global regulatory requirements and quality systems
+ Experience with internal, external or regulatory audits and inspections
+ Strong communication, leadership, and project management skills
Travel, Motor Vehicle Record & Physical/Environment Requirements:
+ Ability to travel - 20% of the time
Aldevron, a Danaher operating company, offers a broad array of comprehensive, competitive benefit programs that add value to our lives. Whether it's a health care program or paid time off, our programs contribute to life beyond the job. Check out our benefits at Danaher Benefits Info ( .
#LI-GC1
Join our winning team today. Together, we'll accelerate the real-life impact of tomorrow's science and technology. We partner with customers across the globe to help them solve their most complex challenges, architecting solutions that bring the power of science to life.
For more information, visit .
Danaher Corporation and all Danaher Companies are committed to equal opportunity regardless of race, color, national origin, religion, sex, age, marital status, disability, veteran status, sexual orientation, gender identity, or other characteristics protected by law.
The U.S. EEO posters are available here ( .
We comply with federal and state disability laws and make reasonable accommodations for applicants and employees with disabilities. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact: or .

**Position Overview**
The Director Quality Systems is responsible for developing, implementing, and maintaining individual sub-systems of the Pharmaceutical Quality Systems (PQS) for FUJIFILM Biotechnologies in TX. Responsibilities will include one or more PQS sub-system: Internal Audit, External (Customer) Audit, Health Authority Inspection, and Remediation. Lead the assigned team to create a strong quality culture of engaged and motivated staff maintaining strong working relationships with internal and external stakeholders. Ensure the site PQS sub-system is aligned with the harmonized global FUJIFILM Biotechnologies PQS, organizational goals and objectives, and areas of continuous improvement.
**Company Overview**
The work we do at FUJIFILM Biotechnologies Texas has never been more important-and we are looking for passionate, mission-driven people like you who want to make a real difference in people's lives.
From developing the next vaccine to advancing cell and gene therapies, we collaborate with industry leaders to tackle complex challenges and deliver meaningful solutions.
If you're ready to help transform the future of medicine, join FUJIFILM Biotechnologies. We offer a flexible work environment and we're proud to cultivate a culture that will fuel your passion, energy, and drive-what we call Genki.
Our state-of-the-art biomanufacturing facility is located in in College Station, Texas, which combines a small-town feel with vibrant culture, top-notch schools, and close proximity to big city life. Nestled between major hubs, it's a dynamic location that blends convenience with innovation.
Fujifilm is globally headquartered in Tokyo with over 70,000 employees across four key business segments of healthcare, electronics, business innovation, and imaging. We are guided and united by our Group Purpose of "giving our world more smiles." Visit: Description**
**_Primary Responsibilities:_**
+ Develop, implement, and maintain the risk-based PQS sub-systems to meet all CGMP regulatory requirements for phase-appropriate clinical and commercial bulk drug substance and drug product manufacture.
+ Establish governance and oversight processes to ensure the organization is continuously complying with site and global quality standards, regulatory requirements, and partner commitments.
+ Lead the Quality Compliance team to deliver exceptional performance of each assigned sub-system.
+ Internal Audit.
+ External (Customer) Audit.
+ Health Auditory Inspection & Remediation.
+ Liaise with internal and external stakeholders to achieve expected business outcomes.
+ Partner with Quality Compliance to ensure the site is inspection ready at all times.
+ Implement audit/inspection learnings within the site QMS; share learnings between FDB sites.
+ Identify areas of risk and/or continuous improvement; escalate/communicate as appropriate.
+ Provide expert guidance and interpretation on regulatory requirements.
+ Recruit, hire, and manage the team in line with FDBT policies and practices.
+ Ability to serve as deputy for Senior Director Quality Systems.
+ Any other duties as assigned.
**_Qualifications:_**
+ Bachelor's degree with 10+ years of relevant experience in a regulated pharmaceutical, biotechnology, or supporting a CDMO environment; OR,
+ Associate's degree with 12+ years of relevant experience in a regulated pharmaceutical, biotechnology, or supporting a CDMO environment.
+ 6+ years of experience in a supervisory or managerial role.
+ 5+ years of experience working with biologics (vaccines, gene therapy, mAb, etc.) in a QA or QC role.
+ Experience with biologics - vaccines, gene therapy, mAb, etc., preferred.
+ Experience within CDMO preferred.
+ Advanced Degree preferred.
+ ASQ Certification preferred.
+ Expert understanding of Pharmaceutical Quality Systems.
+ Excellent written and oral communication skills.
+ Excellent organizational, analytical, data review and report writing skills.
+ Ability to set personal performance goals and provide input to departmental objectives.
+ Develop staff to maximize contributions to the team and the company.
+ Ability to multitask and easily prioritize work.
+ Ability to work independently with little supervision.
+ Proficient in Microsoft Excel, Word and PowerPoint.
+ All candidates must have a working knowledge of CGMP regulations for the production of drug substance, drug product, biologics, vaccine, and/or advanced therapy products.
**_Working Conditions & Physical Requirements:_**
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to:
+ Experience prolonged standing, some bending, stooping, and stretching.
+ Ability to sit for long periods to work on a computer.
+ Ability to wear personal protective equipment including but not limited to safety glasses, lab coat, gloves, specialized clothing including laboratory scrubs (pants and shirt), cleanroom (ISO 8 to ISO 5) gowning material and appropriate shoes required in most areas associated with this position.
+ Lifting up to 25 pounds on occasion.
+ Use hand-eye coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator, and other office equipment is required.
+ Must be willing to work flexible hours.
+ Ability to work weekends and off-shift hours, as needed to support manufacturing activities.
+ Must be willing to travel occasionally, as needed.
+ Attendance is mandatory.
_To all agencies: Please, no phone calls or emails to any_ _employee of FUJIFILM about this requisition. All resumes submitted by search firms/employment agencies to any employee at FUJIFILM via-email, the internet or in any form and/or method will be deemed the sole property of FUJIFILM, unless such search firms/employment agencies were engaged by FUJIFILM for this requisition and a valid agreement with FUJIFILM is in place. In the event a candidate who was submitted outside of the FUJIFILM agency engagement process is hired, no fee or payment of any kind will be paid._
**EEO Information**
Fujifilm is committed to providing equal opportunities in hiring, promotion and advancement, compensation, benefits, and training regardless of nationality, age, gender, sexual orientation or gender identity, race, ethnicity, religion, political creed, ideology, national, or social origin, disability, veteran status, etc.
**ADA Information**
If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to our HR Department ( or ).
**Job Locations** _US-TX-College Station_
**Posted Date** _2 months ago_ _(8/15/2025 1:20 PM)_
**_Requisition ID_** _ _
**_Category_** _Quality Assurance_
**_Company (Portal Searching)_** _FUJIFILM Biotechnologies_

Our client is looking for a highly organized and observant Remote Specialist to conduct detailed audits of commercial cleaning operations. This is a fully remote position, allowing you to work from anywhere in the US. You will be responsible for reviewing documentation, analyzing operational procedures, and providing comprehensive reports on cleaning standards, safety protocols, and environmental compliance for various commercial facilities. Your role is critical in ensuring that our clients' cleaning services meet stringent quality and regulatory requirements.

The ideal candidate will possess exceptional attention to detail, strong analytical skills, and the ability to meticulously assess complex operational data. You will conduct virtual site inspections using provided multimedia resources and client-provided data. This involves identifying areas of non-compliance, potential risks, and opportunities for improvement in sanitation and hygiene practices. You will need to communicate effectively with on-site personnel via virtual means to gather necessary information and clarify findings. Developing detailed, actionable reports that clearly outline your observations and recommendations for corrective actions is a primary function of this role. The ability to work independently, manage your time effectively, and meet strict deadlines is paramount. Experience in quality assurance, auditing, or the cleaning and sanitation industry is highly preferred. This role demands a proactive approach to problem-solving and a commitment to maintaining the highest standards of cleanliness and safety in commercial environments. As a remote specialist, you will be a key remote asset for our client's quality control initiatives, ensuring consistent high performance across their portfolio of managed properties.

Responsibilities:

• Conduct remote audits of commercial cleaning services and operations.
• Review cleaning plans, schedules, and incident reports.
• Analyze data to assess compliance with health, safety, and environmental regulations.
• Identify and document non-compliance issues and areas for improvement.
• Prepare detailed audit reports with clear findings and recommendations.
• Communicate findings and recommendations to stakeholders.
• Maintain accurate and up-to-date records of audit activities.

Requirements:

• Proven experience in auditing, quality assurance, or a related field.
• Strong analytical and problem-solving skills.
• Exceptional attention to detail and organizational abilities.
• Excellent written and verbal communication skills.
• Ability to work independently and manage time effectively.
• Familiarity with cleaning industry standards and best practices is a significant advantage.
• Proficiency in using digital tools for reporting and communication.

The Office of Internal Audit is seeking a **_Sr. Internal Auditor_** that will perform the duties and responsibilities of an Internal Auditor, such as:
**Specific Duties & Responsibilities**
+ Serve as the lead in the development, implementation, and evaluation of financial, operational, and compliance internal audits for assigned organizational areas and functional activities throughout The Johns Hopkins Institutions (Johns Hopkins University and Johns Hopkins Medicine) in accordance with the Annual Audit Plan approved by the respective Audit Committees.
+ Set clear expectations for audit team, coordinate assignments, monitor productivity, and ensure high quality output.
+ Will serve as technical resource to other team members.
_Performs assigned duties in accordance with the accepted professional standards requiring._
+ Independence and objectivity, knowledge of accounting principles and standards, proper financial and administrative control procedures and good business practices, and ability to assess risk, relative to the proper application of controls.
+ Serve as a leader and a role model.
+ Promotes Department image through quality work, sharing knowledge and professional dealings and maintain confidentiality of information.
+ Document current operating practices through interviews, observation, investigation and testing.
+ Test transactions (utilizing automated and/or traditional auditing methods) and analyze results of testing.
+ Identify through investigation and analysis, underlying causes and contributing factors to noted problems.
+ Identify and assess risks.
+ Identify appropriate solutions and formulates sound reasonable recommendations for management's corrective action, using appropriate criteria and cost-benefit considerations.
+ Prepare formal written reports, expressing conclusion on the adequacy and effectiveness of the system and the efficiency with which activities are carried out.
_In addition to performing the duties of an Internal Auditor, will also,_
+ Plan internal audits by gathering specific relevant background information (such as financial results, and policies and procedures) from the Institution's information systems, web-based and other information sources.
+ Utilize organizational and regulatory knowledge to identify audit constraints and shape priorities.
+ Negotiate audit parameters with Manager/ Sr. Director.
+ If leading a team, will ensure that all members understand their individual roles and responsibilities.
+ Design appropriate internal audit programs and time budgets based upon the review and evaluation of underlying financials and business risks.
+ Thoroughly address all objectives and risks identified in audit planning and conclude on operational effectiveness and efficiency, considering industry best practices.
+ Prepare clear and concise working papers and other documentation supporting discussions, operational facts and results of testing to justify conclusions.
+ When serving in a project lead role, will review all working papers related to the project.
+ Communicate recommendations to management through logical, clear and concise written and oral means to gain understanding and agreement on audit issues and commitment to implement corrective action.
+ Perform follow-up internal audits to evaluate management's implementation of Action Plans.
+ Monitor project status and issues on a timely basis and report progress and issues to project lead or director timely and regularly.
+ Evaluate feedback from customers as well as lessons learned meetings and identify possible areas for improvement. Implement changes in future audits as needed.
+ Oversee the activities of Internal Auditors to ensure effective utilization in completing assigned projects. Provide day-to-day support of Internal Auditors as needed (create open lines of communication, provide regulatory updates, advise on difficult situations, etc.).
+ Participate in personnel development training and performance evaluation programs.
+ May provide oral feedback to staff assigned or to the director for inclusion in staff performance or project evaluation.
+ Assist other Auditors as appropriate and necessary to execute assigned projects.
+ Consider multiple approaches and develop solutions to problems.
+ Demonstrate project management and time management skills.
+ Address difficult and sensitive issues in a timely and effective manner.
+ May be responsible for more complex audits than those handled by Internal Auditors (act as lead on a multi-entity audit requiring coordination of several other auditors, implement a new audit with no available history or background, responsible for high visibility/high priority audits, etc.).
+ May also have a higher volume of audits.
+ Demonstrate a thorough understanding of healthcare and/or Higher Education industry.
+ Monitor changes in the industry and be able to understand the impact to own work.
_Decision Making_
+ On a regular and continuous basis, exercises administrative judgment and assumes responsibility for decisions, consequences and results having an impact on people, costs and/or quality of service within the functional area.
_Authority_
+ In accordance with Department policy, can make all decisions necessary to carry out assigned projects and related internal audit and work programs to meet the audit objectives. May direct the activities of staff or a function and /or represent the function at meetings.
_Communication_
+ Uses proper oral, written and interpersonal communication skills. Exchanges information using tact and persuasion, as appropriate. Effectively shares relevant information with assigned team and fosters dialogue as necessary.
_Machines and/or Equipment used on the Job; Include % of time used_
+ Computer or other special needs for the position.
+ Excellent problem solving and analytical skills.
+ Experience with ACL, Microsoft Office, SAP and automated workpapers.
+ Utilize advanced knowledge of Microsoft Office Suite and other business and audit-related software to conduct internal audit work as well as the extraction of relevant business data and its analysis using ACL software.
_Degree of independent action performed on the Job_
+ Able to work independently and with varying levels of management. Manage multiple projects or single projects in complex environments. Manage competing priorities.
_Internal and External contacts required as part of the job_
+ Interact appropriately with all levels of personnel, building good working relationships, and establishing a network of organizational contacts. Knows the formal and informal departmental goals, standards, policies and procedures, which may include some familiarity of other departments within the JH Institution. Is sensitive to the interrelationship of both people and functions throughout the organization. Responsible for own professional development and contributes to the development of others.
**Minimum Qualifications**
+ Bachelor's Degree in Accounting, Business, or related field required.
+ Five or more years Accounting or Audit Experience required.
**Preferred Qualifications**
+ Certified Public Accountant (CPA), Certified Internal Auditor (CIA) or Masters in Business Administrations (MBA) preferred.
+ Supervisory experience.
+ Non-profit, Higher Education and/or Healthcare industry experience preferred.
Classified Title: Sr. Internal Auditor
Role/Level/Range: ATP/04/PD
Starting Salary Range: $62,900 - $110,100 Annually (Commensurate with experience)
Employee group: Full Time
Schedule: M-F 8:30-5
Exempt Status: Exempt
Location: Hybrid/Eastern High Campus
Department name: Johns Hopkins University Core Processes
Personnel area: University Administration
The listed salary range represents the minimum and maximum Johns Hopkins University offers for this position, based on a good faith estimate at the time of posting. Actual compensation will vary depending on factors such as location, skills, experience, market conditions, education, and internal equity. Not all candidates will qualify for the highest salary in the range.
Johns Hopkins provides a comprehensive benefits package supporting health, career, and retirement. Learn more: Opportunity Employer
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
EEO is the Law

**Duration: 6 months (Hybrid)**
**Job Description:**
+ We are seeking an experienced Security Ops Compliance/Audits Program Manager to provide compliance and security program support. This role sits within a high-impact audit and compliance team supporting key audit readiness initiatives across one of client's largest product areas.
+ The successful candidate will bring a strong background in program management, along with preferred experience in IT/security compliance and audits operations.
+ You will be coordinating with engineers, product teams, and cross-functional stakeholders to ensure audit activities remain on track and compliant.
+ This is not a role for designing new systems - it's about "keeping the lights on" and maintaining current standards with precision and urgency.
**Key Responsibilities:**
+ Maintain and update program trackers and dashboards to provide visibility into project status, timelines, milestones, and deliverables.
+ Define, track, and report on key performance indicators (KPIs) and compliance metrics to measure program health and audit readiness progress.
+ Regularly communicate program status updates, risks, and success metrics to leadership and key stakeholders through structured reporting.
+ Serve as the operational point of contact to maintain and track audit readiness activities across assigned product areas.
+ Coordinate with engineering and product teams to validate compliance with audit controls (e.g., ISO 27001, SOX).
+ Monitor and ensure completion of critical activities such as annual penetration testing, documentation, and procedural checks.
+ Drive follow-ups with stakeholders to meet non-negotiable compliance deadlines.
+ Work within existing playbooks, standard operating procedures (SOPs), and documentation frameworks.
+ Escalate roadblocks, non-compliance risks, or resourcing concerns as needed.
**Top Required Skills & Qualifications:**
+ Program Management Experience (Minimum 2 Years)
+ Proven ability to manage complex programs with minimal supervision.
+ Experience managing project timelines, risks, and metrics using tools like Jira, Smartsheet, or equivalent program tracking platforms.
+ Strong skills in developing and maintaining KPIs, audit track
+ Audit or Compliance Experience (Strongly Preferred)
+ Knowledge of ISO 27001, SOX, and related audit frameworks.
+ Familiarity with controls, audit cycles, and readiness best practices.
+ Security / IT Operations Background (Strongly Preferred)
+ Understanding of IT security concepts such as access management, business continuity, pen testing, and vulnerability management.
**Preferred Certifications:**
+ PMP or equivalent Project Management certification.
+ CISA, CISSP, or ISO 27001 Lead Implementer.
**Education:**
+ Bachelor's degree or equivalent industry experience.
**About US Tech Solutions:**
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

**Job Description**
**Work hours will be 7am-3:30pm PST M-F**
**Job Summary**
Responsible for conducting various healthcare Healthcare claim audits including, but not limited to; vendor, focal, audit the auditor. Confirm that documentation is clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains to contracting (benefit and provider), network management, credentialing, prior authorizations, fee schedules, and other business requirements critical to claim accuracy. Maintain audit records, and provide counsel regarding coverage amount and benefit interpretation within the audit process. Provide clear and concise results and comments to leaders about focal audits. Contributes to completion of audits as needed to ensure audits are conducted in a timely fashion and in accordance with audit standards.
**Job Duties**
- Reviews documentation regarding updates/changes to member enrollment, provider contract, provider demographic information, and/or claim processing guidelines. Evaluates the accuracy of these updates/changes as applied to the appropriate modules within the core processing system (QNXT).
- Conducts focal healthcare Medical claim audits on samples of processed transactions impacted by these updates/changes. Determines that all outcomes are aligned to the original documentation and allow appropriate processing.
- Conducts audits of vendor audits and verifies accuracy of their published outcomes are aligned to the documentation, various sources of truth and being assessed appropriately.
- Clearly documents the focal audit results and makes recommendations as necessary.
- Researches and tracks the status of unresolved errors issued on daily transactional audits and communicates with Core Operations Functional Business Partners to ensure resolution within 30 days of error issuance.
- Evaluates the adjudication of claims using standard principles and state specific policies and regulations in order to identify incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and processing errors of claims. ( _Use for claims specific positions only_ )
- Prepares, tracks and provides audit findings reports according to designated timelines
- Presents audit findings and makes recommendations to management for improvements based on audit results.
**Job Qualifications**
**REQUIRED EDUCATION:**
Associate's Degree or equivalent combination of education and experience
**REQUIRED EXPERIENCE, SKILLS & ABILIITIES:**
+ Minimum 2 years as an operational auditor for at least one core operations function
+ Previous examiner/processing experience in at least one core operations functional area
+ Strong attention to detail
+ Knowledge of using Microsoft applications to include; Excel, Word, Outlook, Powerpoint and Teams
+ Ability to effectively communicate written and verbal
+ Knowledge of verifying documentation related to updates/changes within claims processing system .
+ Experience using claims processing system (QNXT).
**PREFERRED EDUCATION:**
Bachelor's Degree or equivalent combination of education and experience
**PREFERRED EXPERIENCE:**
3+ years healthcare Medical claims auditing
**PHYSICAL DEMANDS:**
Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $21.16 - $42.2 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

**Job Description**
**Work hours will be 7am-3:30pm PST M-F**
**Job Summary**
Responsible for conducting various healthcare Healthcare claim audits including, but not limited to; vendor, focal, audit the auditor. Confirm that documentation is clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains to contracting (benefit and provider), network management, credentialing, prior authorizations, fee schedules, and other business requirements critical to claim accuracy. Maintain audit records, and provide counsel regarding coverage amount and benefit interpretation within the audit process. Provide clear and concise results and comments to leaders about focal audits. Contributes to completion of audits as needed to ensure audits are conducted in a timely fashion and in accordance with audit standards.
**Job Duties**
- Reviews documentation regarding updates/changes to member enrollment, provider contract, provider demographic information, and/or claim processing guidelines. Evaluates the accuracy of these updates/changes as applied to the appropriate modules within the core processing system (QNXT).
- Conducts focal healthcare Medical claim audits on samples of processed transactions impacted by these updates/changes. Determines that all outcomes are aligned to the original documentation and allow appropriate processing.
- Conducts audits of vendor audits and verifies accuracy of their published outcomes are aligned to the documentation, various sources of truth and being assessed appropriately.
- Clearly documents the focal audit results and makes recommendations as necessary.
- Researches and tracks the status of unresolved errors issued on daily transactional audits and communicates with Core Operations Functional Business Partners to ensure resolution within 30 days of error issuance.
- Evaluates the adjudication of claims using standard principles and state specific policies and regulations in order to identify incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and processing errors of claims. ( _Use for claims specific positions only_ )
- Prepares, tracks and provides audit findings reports according to designated timelines
- Presents audit findings and makes recommendations to management for improvements based on audit results.
**Job Qualifications**
**REQUIRED EDUCATION:**
Associate's Degree or equivalent combination of education and experience
**REQUIRED EXPERIENCE, SKILLS & ABILIITIES:**
+ Minimum 2 years as an operational auditor for at least one core operations function
+ Previous examiner/processing experience in at least one core operations functional area
+ Strong attention to detail
+ Knowledge of using Microsoft applications to include; Excel, Word, Outlook, Powerpoint and Teams
+ Ability to effectively communicate written and verbal
+ Knowledge of verifying documentation related to updates/changes within claims processing system .
+ Experience using claims processing system (QNXT).
**PREFERRED EDUCATION:**
Bachelor's Degree or equivalent combination of education and experience
**PREFERRED EXPERIENCE:**
3+ years healthcare Medical claims auditing
**PHYSICAL DEMANDS:**
Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $21.16 - $42.2 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

**Job Description**
**Work hours will be 7am-3:30pm PST M-F**
**Job Summary**
Responsible for conducting various healthcare Healthcare claim audits including, but not limited to; vendor, focal, audit the auditor. Confirm that documentation is clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains to contracting (benefit and provider), network management, credentialing, prior authorizations, fee schedules, and other business requirements critical to claim accuracy. Maintain audit records, and provide counsel regarding coverage amount and benefit interpretation within the audit process. Provide clear and concise results and comments to leaders about focal audits. Contributes to completion of audits as needed to ensure audits are conducted in a timely fashion and in accordance with audit standards.
**Job Duties**
- Reviews documentation regarding updates/changes to member enrollment, provider contract, provider demographic information, and/or claim processing guidelines. Evaluates the accuracy of these updates/changes as applied to the appropriate modules within the core processing system (QNXT).
- Conducts focal healthcare Medical claim audits on samples of processed transactions impacted by these updates/changes. Determines that all outcomes are aligned to the original documentation and allow appropriate processing.
- Conducts audits of vendor audits and verifies accuracy of their published outcomes are aligned to the documentation, various sources of truth and being assessed appropriately.
- Clearly documents the focal audit results and makes recommendations as necessary.
- Researches and tracks the status of unresolved errors issued on daily transactional audits and communicates with Core Operations Functional Business Partners to ensure resolution within 30 days of error issuance.
- Evaluates the adjudication of claims using standard principles and state specific policies and regulations in order to identify incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and processing errors of claims. ( _Use for claims specific positions only_ )
- Prepares, tracks and provides audit findings reports according to designated timelines
- Presents audit findings and makes recommendations to management for improvements based on audit results.
**Job Qualifications**
**REQUIRED EDUCATION:**
Associate's Degree or equivalent combination of education and experience
**REQUIRED EXPERIENCE, SKILLS & ABILIITIES:**
+ Minimum 2 years as an operational auditor for at least one core operations function
+ Previous examiner/processing experience in at least one core operations functional area
+ Strong attention to detail
+ Knowledge of using Microsoft applications to include; Excel, Word, Outlook, Powerpoint and Teams
+ Ability to effectively communicate written and verbal
+ Knowledge of verifying documentation related to updates/changes within claims processing system .
+ Experience using claims processing system (QNXT).
**PREFERRED EDUCATION:**
Bachelor's Degree or equivalent combination of education and experience
**PREFERRED EXPERIENCE:**
3+ years healthcare Medical claims auditing
**PHYSICAL DEMANDS:**
Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $21.16 - $42.2 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

**Job Description**
**Work hours will be 7am-3:30pm PST M-F**
**Job Summary**
Responsible for conducting various healthcare Healthcare claim audits including, but not limited to; vendor, focal, audit the auditor. Confirm that documentation is clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains to contracting (benefit and provider), network management, credentialing, prior authorizations, fee schedules, and other business requirements critical to claim accuracy. Maintain audit records, and provide counsel regarding coverage amount and benefit interpretation within the audit process. Provide clear and concise results and comments to leaders about focal audits. Contributes to completion of audits as needed to ensure audits are conducted in a timely fashion and in accordance with audit standards.
**Job Duties**
- Reviews documentation regarding updates/changes to member enrollment, provider contract, provider demographic information, and/or claim processing guidelines. Evaluates the accuracy of these updates/changes as applied to the appropriate modules within the core processing system (QNXT).
- Conducts focal healthcare Medical claim audits on samples of processed transactions impacted by these updates/changes. Determines that all outcomes are aligned to the original documentation and allow appropriate processing.
- Conducts audits of vendor audits and verifies accuracy of their published outcomes are aligned to the documentation, various sources of truth and being assessed appropriately.
- Clearly documents the focal audit results and makes recommendations as necessary.
- Researches and tracks the status of unresolved errors issued on daily transactional audits and communicates with Core Operations Functional Business Partners to ensure resolution within 30 days of error issuance.
- Evaluates the adjudication of claims using standard principles and state specific policies and regulations in order to identify incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and processing errors of claims. ( _Use for claims specific positions only_ )
- Prepares, tracks and provides audit findings reports according to designated timelines
- Presents audit findings and makes recommendations to management for improvements based on audit results.
**Job Qualifications**
**REQUIRED EDUCATION:**
Associate's Degree or equivalent combination of education and experience
**REQUIRED EXPERIENCE, SKILLS & ABILIITIES:**
+ Minimum 2 years as an operational auditor for at least one core operations function
+ Previous examiner/processing experience in at least one core operations functional area
+ Strong attention to detail
+ Knowledge of using Microsoft applications to include; Excel, Word, Outlook, Powerpoint and Teams
+ Ability to effectively communicate written and verbal
+ Knowledge of verifying documentation related to updates/changes within claims processing system .
+ Experience using claims processing system (QNXT).
**PREFERRED EDUCATION:**
Bachelor's Degree or equivalent combination of education and experience
**PREFERRED EXPERIENCE:**
3+ years healthcare Medical claims auditing
**PHYSICAL DEMANDS:**
Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $21.16 - $42.2 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.