3,496 Compliance Auditor jobs in the United States

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The Compliance Auditor will be responsible for facilitating Client audits and supporting internal compliance operations.  The Compliance Auditor may be responsible for fielding questions throughout Client audits, representing MTM in a professional and positive manner and interpret contract requirements as it relates to MTM’s operational procedures, compliance with state and federal regulations and contract compliance. The Compliance Auditor will oversee policies and procedures, provide needed support during the URAC accreditation process, and manage other projects, as required.

Location: Hybrid/Remote if located within 40 miles of an MTM office.

What you’ll do:

• Plan and implement effective audit processes for both internal and external audits

• Facilitate remote and on-site external audits

• Interpret contract requirements and communicate expectations to needed internal stakeholders

• Support in the development and utilization of internal controls to ensure continuous compliance

• Help implement risk management strategies for the organization(s)

• Utilize the selected tracking method to record audit investigations, documentation, results, and recommendations

• Compile quarterly, and upon request, summaries of audit investigations, findings, and resolutions

• Continuously promote process improvement and process integrity throughout the organization(s) while partnering with other departments to develop practical solutions

• Assist and guide process owners in the assessment of processes for improvement and standardization opportunities, while minimizing rework, reducing cost, and improving quality output

• Assist with the creation, review, and update of MTM policies and procedures to ensure thorough and pertinent documentation; oversee MTM (and affiliates) policies, procedures, manuals, and processes to ensure contractual compliance and process efficiency

• Act as a liaison between MTM and/or affiliates and external auditors

• Report compliance concerns to the Compliance Officer, Director of Compliance and Audit and other executive staff as indicated

• Prepare for external audits by completing audit tools, compiling supporting documentation for audit sample, and referencing policies, procedures, and contracts to validate compliance

• Conduct monitoring, reporting, and follow-up on all Corrective Action Plans

• Apply policies/procedures and client contract obligations to designated audits

• Create relevant workflows, audit tools, and tracking mechanisms as assigned

• Provide any needed support to ensure ongoing compliance with URAC standards

• Assist in developing audit reports and presenting findings and recommendations to leadership, as needed

• As needed, conduct quality improvement projects for the Quality Improvement Program

• Assist with the development and execution of compliance program activities and projects as assigned

What you’ll need:

Experience, Education & Certifications:

• High School Diploma or G.E.D.

• Bachelor’s Degree or equivalent experience in compliance

• At least 2 years’ experience in an Auditor/Compliance role

• Experience working with MCO contracts or other state clients, monitoring contract and regulatory compliance

Skills:

• Must possess the ability to assess potential problems and make sound judgments around issues that may have an adverse effect on the business

• Detail-oriented, thorough, and a systematic/methodical approach to projects

• Strong project management

• Ability to present complex information in a simple and compelling manner

• Ability to multi-task, set priorities and meet deadlines

• Proficient in Microsoft applications (Word, Excel, Outlook, PowerPoint, SharePoint)

• Strong people management skills

• High level of emotional intelligence

• Excellent interpersonal skills

• Ability to work well under pressure

• Ability to work independently and also collaboratively with others to achieve defined goals

• Excellent written and oral communication skills

• Outstanding analytical and organizational skills

• Ability to maintain high level of confidentiality

• Regular attendance is required

• Ability to identify areas of improvement and provide recommendations

Even better if you have.

• Previous experience in Medicaid or state public assistance programs preferred

• Experience working for a managed care organization or healthcare provider preferred

What’s in it for you:

• Health and Life Insurance Plans

• Dental and Vision Plans

• 401(k) with a company match

• Paid Time Off and Holiday Pay

• Maternity/Paternity Leave

• Casual Dress Environment

• Tuition Reimbursement

• MTM Perks Discount Program

• Leadership Mentoring Opportunities

Salary Min: $47,920

Salary Max: $71,880

This information reflects the base salary pay range for this job based on current national market data. Ranges may vary based on the job's location. We offer competitive pay that varies based on individual skills, experience, and other relevant factors. We encourage you to apply to positions that you are interested in and for which you believe you are qualified. To learn more, you are welcome to discuss this with us as you move through the selection process.

Equal Opportunity Employer: MTM is an equal opportunity employer.  MTM considers qualified candidates with a criminal history in a manner consistent with the requirements of applicable local, State, and Federal law.  If you are in need of accommodations, please contact MTM’s People & Culture.

#MTM

• Bachelor's Degree in Health Care Administration, Business or related field and experience in coding, billing, and/or reimbursement.
• In lieu of degree, three to five years of equivalent work experience will be accepted.
• Certified AAPC (American Academy of Professional Coders) or AHIMA (American Health Information Management Association).
• Proficient in Microsoft Office (Word, PowerPoint and/or Visio).
• Advanced skills in Microsoft Excel.
• Strong quantitative and analytical skills.
• Excellent verbal and written communication skills.
• Excellent presentation skills.

• Additional certification such as CHC, CCS, etc.
• Working knowledge of Epic.

• May need to move around intermittently during the day, including sitting, standing, stooping, bending, and ambulating.
• May need to remain still for extended periods, including sitting and standing.
• Ability to communicate in face-to-face, phone, email, and other communications.
• Ability to read job related documents.
• Ability to use computer.

• Accurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient encounter visit for the purpose of appropriate reimbursement, research and compliance with federal and state regulations according to established ICD-10-CM/PCS coding and/or CPT-4 procedure coding classification systems.

• Serves as a clinical coding subject matter expert, and utilizes critical thinking to analyze and evaluate documentation issues with consultation from the medical and clinical staff, and clinical documentation specialists as needed.
• Audits ICD-10 diagnostic codes and CPT-4 procedure codes to outpatient, ambulatory surgery, and observation visits for the purpose of reimbursement, research and compliance with federal and state regulations.
• Audits complex inpatient cases such as trauma, rehab, neurology, critical care, etc. utilizing the ICD-10-CM and ICD-10-PCS nomenclature to ensure accurate APR-DRG/SOI/ROM and POA assignment.

• High School graduate or equivalent. Formal ICD-10-CM, ICD-10-PCS, CPT-4 training. Associates or Bachelor's degree. Education will be considered in lieu of experience.
• Minimum of two years ICD-10-CM/ICD-10-PCS coding and abstracting experience with at a Level 1 Trauma hospital or 4 years of experience with coding inpatient hospital medical records. 2-3 Years Ambulatory coding experience.
• One of the following: Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Inpatient Coder (CIC)

• Strong analytical and organizational skills; filing systems; ability to prioritize workloads; meet deadlines and work effectively under pressure; excellent customer service skills; general office procedures; ability to problem solve and work with minimal supervision; familiar with basic medical terminology; computer experience; typing ability.

• Conduct Compliance Reviews
• Complete compliance reviews within established parameters and initiate and carry out all assigned reviews according to defined departmental policies and processes.
• Reviewing medical records and documents to abstract clinical data for HEDIS reporting.
• Integrating electronic and hardcopy data into reports.
• Preparing and presenting HEDIS compliance reports to health facility managers.
• Training and advising clinicians and care team staff on HEDIS compliance.
• Keeping abreast of HEDIS measures.

• Apply communication skills by coordinating patient services and requests, including addressing patient phone calls, telephone encounters, and patient portal queries as well as to follow up with patients after their appointments, provide appointment reminders, to follow-up on missed appointments, etc.
• Adheres to all clinic policies and procedures, as well as applicable state, federal, and other regulatory guidelines
• Maintains all necessary licensure, certification(s), including BLS. Attends annual fire and safety classes
• Attends and participates in all assigned meetings, reports, and/or committees
• Performs other duties as assigned.

• Ex State-approved licensing and registration as a nurse (RN, LPN, or LVN)
• Current CPR (BLS) Certification
• Bilingual (in Spanish) preferred
• Extensive experience with HEDIS database entries and reporting.
• In-depth knowledge of abstracting clinical data and evaluating HEDIS compliance.
• Advanced knowledge of medical terminology, coding, and procedures.
• Extensive experience in interpreting and reporting HEDIS information, as well as training staff.
• Excellent organizational and communication skills.
• Ability to work with people of diverse cultural, educational, social, and economic backgrounds.
• Ability to work independently and a self-starter with minimal supervision
• Computer proficiency
• Experience utilizing an Electronic Medical Records (EMR) system is highly desirable

• Medical, Dental, Vision
• Monthly employer-sponsored allowance for assistance with health premiums.
• Funded Health Savings Account (up to deductible) to assist with carrier-approved medical expenses.
• Paid time off (vacation, sick leave) and 13 paid holidays.
• 401(k) Safe Harbor Profit Sharing plan.
• Mileage reimbursement.
• Short- and long-term disability plans (LTD/STD).
• Life insurance policy & AD&D, and more!

Join to apply for the Senior Compliance Auditor role at Farmers & Merchants Bank of Long Beach 2 days ago Be among the first 25 applicants Join to apply for the Senior Compliance Auditor role at Farmers & Merchants Bank of Long Beach Get AI-powered advice on this job and more exclusive features. Farmers & Merchants Bank of Long Beach provided pay range This range is provided by Farmers & Merchants Bank of Long Beach. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $78,527.00/yr - $35,551.00/yr Job Summary The Senior Compliance Auditor supports the Compliance Audit Manager in the completion of the annual audit plan by planning and conducting compliance internal audits, performing audit in-charge responsibilities, and conforming to the Internal Audit Charter and Standards. Compliance internal audits include, but are not limited to Bank Secrecy Act, Fair Lending, Branch Operations Compliance, Lending Compliance (commercial and consumer), SAFE Act, HMDA, CRA, UDAAP, Regulation B, and Regulation E as well as Compliance Management System. Essential Duties Plan, execute, and report on results of assigned Compliance audits, including the following: Assist assigned auditors in developing/updating audit programs, checklists and/or guides associated with Compliance related audit entities. Perform and document internal control walkthroughs of key processes, risks and controls, compliance with laws and regulations, and design/effectiveness of internal controls. Prepare process narratives, flow charts and descriptions of internal controls. Identify control deficiencies and improvement opportunities and provide recommendations for management’s corrective/improvement action plans. Review work of assigned auditors and/or co-source staff. Prepare complete, accurate, clear, and concise audit workpaper documentation with proper supporting artifacts. Compile and analyze audit issues identified in the audit including root cause and risk impact analysis. Prepare draft audit reports. Organize and conduct meetings with management upon commencement and completion of engagements to discuss audit scope, engagement status, and significant audit issues identified. Effectively perform audit in-charge responsibilities (i.e., planning, workpaper review, report preparation, etc.). Effectively utilize down time, identify issues requiring research, and effectively research using appropriate resources. Complete all assignments within established timeline to enable the issuance of all audit reports and other deliverables by the applicable deadlines. Develop and maintain collaborative working relationships with management, learning and understanding the business to better provide value-added services help management achieve objectives, and manage risks. As directed by the Compliance Audit Manager, assist consultants and regulators in the execution of their audits/examinations. Maintain appropriate knowledge of current and pending compliance laws and regulations. Perform special projects at the request of the Compliance Audit Manager. Maintain a professional development plan to continually develop audit skills and to meet annual training requirements. Complies with all State and Federal Banking regulatory requirements, including but not limited to: BSA, Anti-Money Laundering, OFAC, CIP, Financial Elder Abuse Reporting, Sexual Harassment, Information Security and privacy requirements. This position will elevate suspicious activity to supervisory staff and/or BSA department. Completes compliance and other technical training workshops as assigned. Non-Essential Duties Provide periodic feedback to staff compliance auditors Be familiar with Bank’s practices, policies, and culture Perform other duties as assigned Required Knowledge, Skills And Abilities Banking knowledge –Branch Banking Operations, Lending Operations, compliance-related policy and procedures Knowledge of risk management principles and practices in banks Understanding of IIA standards for the Professional Practice of Internal Auditing, COSO, risk assessment practices, and audit principles Sound judgment, integrity and commitment to ethical behavior Ability to maintain confidentiality and treat sensitive information with discretion Excellent interpersonal and communication skills Highly proficient with MS Office products Strong analytical skills, logical reasoning and problem-solving skills Ability to work independently, with limited direction and guidance Detail oriented, accurate, and organized Ability to effectively manage multiple projects simultaneously Flexible and able to adapt quickly to changing work environments / priorities and tight deadlines Strong business acumen in risk and controls Officer Title Eligibility For qualified positions, the Bank may designate an Officer Title to an employee who seeks and/or meets defined competencies for an eligible position. This position qualifies for the officer title(s) Assistant Vice President. Equipment Operated Desktop/ laptop Computers Standard Office Equipment (copiers) Physical Requirements & Work Environment Requires sitting for prolonged periods of time Requires lifting up to 10 pounds Hybrid work schedule Office setting w/controlled temperature Requires periodic travel to branch locations Education And Experience BS or BA Degree required, preferred majors in Accounting, Business Administration, Finance, or Economics or equivalent work experience required. Five or more years of compliance related experience within a bank compliance/BSA group, a bank internal audit compliance group or regulatory agency required. Regional banking experience is strongly preferred. Strong working knowledge of both Federal and California State consumer protection and public-interest compliance laws and regulations including Regulation Z, Regulation X, Regulation DD, Regulation E, Flood, Fair Lending, CRA, Privacy as well as BSA/AML/OFAC requirements and applicable commercial compliance laws and regulations. Certified Regulatory Compliance Manager (CRCM), Certified Anti-Money Laundering Specialist (CAMS), Certified Internal Auditor (CIA), Certified Information Security Auditor (CISA), or Certified Risk Management Assurance (CRMA) required. Experience with audit software is preferred. Supervisory experience preferred but not required. Data analytics a plus. Working knowledge of AuditBoard, Jack Henry (Silverlake/Xperience), COGNOS a plus. This job description is not intended to be all-inclusive, and employees will be required to perform additional related work duties as assigned by their immediate supervisor and/or management. Farmers and Merchants Bank of Long Beach reserves the right to revise or change job duties and responsibilities as the need arises. This job description does not constitute a written or implied contract of employment. August 15, 2025 Seniority level Seniority level Mid-Senior level Employment type Employment type Contract Job function Job function Finance and Sales Industries Banking Referrals increase your chances of interviewing at Farmers & Merchants Bank of Long Beach by 2x Get notified about new Senior Compliance Auditor jobs in Seal Beach, CA . 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