Auditor

• Assist Associate Auditors, Senior Auditors or Audit Managers with planning and execution of audits within or across Lines of Business or Functions
• Conduct audit planning activities and prepare or revise audit programs
• Perform audit procedures and prepare working papers supporting conclusions
• Test key controls using established standards and protocols
• Utilize Computer Assisted Auditing Tools (CAATs) reports to test controls
• Document audit results, analyze results and test conclusions
• Prepare potential audit issues, identify root causes and recommend improvements to internal controls or operational efficiency
• Communicate audit test results and recommendations to Line of Business management
• Perform special projects and assignments directed by Audit Management
• May supervise Associate Auditors on specific projects or audits
• Communicate audit concerns to supervisors and assist with resolution of high-risk issues
• Develop technical and audit skills and participate in performance management
• Build relationships throughout Internal Audit and within the Line of Business
• Assist Internal Audit Management with recruiting efforts
• Identify pragmatic improvement opportunities and help lead changes

Internal Auditor

• Participate in Sarbanes-Oxley IT General Controls audits and technology-related advisory reviews
• Support risk assessments, IT control evaluations, and advisory engagements involving governance, risk management, information security, and internal controls
• Support reviews of system implementations, cybersecurity, backup and recovery/disaster recovery, and compliance
• Assist with post-acquisition assessments, audit methodology enhancements, audit technology initiatives, data analytics projects, automation opportunities, and quality improvement efforts
• Assist with audit planning, including technology and risk analysis, prior audit result review, and business risk evaluation
• Participate in opening, status, and closing meetings with management and process owners
• Execute audit procedures and control testing, including SOX testing, and document detailed audit workpapers
• Perform analytical procedures and use data analytics to identify trends, anomalies, control weaknesses, and potential risks
• Contribute to data analytics, automation, artificial intelligence, and audit technology improvements
• Evaluate internal control design and operating effectiveness and identify process improvements
• Conduct interviews and meetings to understand processes, risks, controls, and supporting evidence
• Communicate audit observations and assist with root-cause analysis and risk-based recommendations
• Draft audit findings, management recommendations, audit communications, reports, and presentations
• Maintain audit documentation, testing results, findings, and action plans in Optro (AuditBoard)
• Monitor and validate corrective actions responding to audit findings
• Maintain knowledge of IT auditing standards, control frameworks, company policies, cybersecurity risks, emerging technologies, and industry practices
• Establish relationships with personnel throughout the organization

IT Internal Auditor

• Lead on-site audits of hospital billing and coding practices and desk audits
• Develop, profile, and track institutional audit trends
• Design audit protocols and special projects
• Perform and finalize per diem, bill verification, DRG Validation/utilization review audits, and credit balance audits
• Provide guidance and instruction to stakeholders on ICD-10-CM, ICD-10-PCS, DRG assignment, payment, and auditing
• Identify and present billing discrepancies found during audits
• Coordinate referral of improper claim payments through appropriate channels
• Identify error trends related to medical records, billing documentation, and provider contract stipulations
• Compile statistics and audit information for accounts, regulatory agencies, and internal requesters
• Review and update audit processes with the manager to keep pace with clinical data review innovations and cost-containment initiatives
• Train new staff on department and audit procedures
• Perform other special assignments requested by the manager
• Comply with laws, regulations, and policies applicable to organizational business units

Inpatient Hospital Auditor II

• Audit data, claim submissions, and member medical records for completeness, accuracy, and compliance with Healthfirst policy
• Document audit findings according to departmental procedure
• Identify patterns of under-performance, noncompliance, and inconsistencies and recommend resolutions
• Evaluate medical coding quality and notify management of discrepancies
• Conduct internal audits of medical record reviews performed by colleagues
• Collaborate with departments to improve compliance with coding conventions and clinical practice guidelines
• Support continuous improvement and quality initiatives across departments
• Perform additional duties as assigned

Auditor jobs in Connecticut

Internal Auditor

IT Internal Auditor

Inpatient Hospital Auditor II

Coding Auditor