63 senior internal auditor jobs found

The Diagnostic Related Groups (DRG) Clinical Auditor will be responsible for performing DRG validation (clinical/coding) reviews of medical records and/or other documentation. This role will determine correct DRG/coding as defined by review methodologies specific to the type of review. This involves completing medical record reviews, accurately documenting findings and non-findings and providing clinical/policy/regulatory support for the determination. This role will utilize their experience with ICD-10-CM & PCS coding guidelines, the ability to understand modern pharmacology, disease management and clinical intervention procedures. The ideal DRG Clinical Auditor candidate has strong written and verbal communication skills, clinical knowledge of disease processes, and knowledge of medical necessity rules. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: The Clinical Auditor will review medical records to determine accuracy of billing through...

Title: Head of  Internal Audit Location: Bedminster, NJ / Austin, TX / San Jose, CA (Hybrid - 3 days in office)  Reporting to: Board of Directors and Chief Risk Officer  About Hippo: Hippo exists to protect the joy of homeownership. We believe that insurance should protect the things you treasure through an intuitive, modern experience. We provide tailored insurance coverage and preventative maintenance plans that keep you protected throughout your homeowner journey. We’ll also help you find coverage for everything life brings—from auto to flood—reimagining how you care for your home. About The Role:   The Head of Internal Audit will lead the Internal Audit function for Hippo. This role oversees all internal audit activity across the company, providing independent, objective assurance and advice to the Board of Directors (via the Audit, Risk and Compliance Committee (ARCC) and senior management on the design adequacy and operating effectiveness of...

Title: Head of  Internal Audit Location: Bedminster, NJ / Austin, TX (Hybrid - 3 days in office)  Reporting to: Board of Directors and Chief Risk Officer  About Hippo: Hippo exists to protect the joy of homeownership. We believe that insurance should protect the things you treasure through an intuitive, modern experience. We provide tailored insurance coverage and preventative maintenance plans that keep you protected throughout your homeowner journey. We’ll also help you find coverage for everything life brings—from auto to flood—reimagining how you care for your home. About The Role:   The Head of Internal Audit will lead the Internal Audit function for Hippo. This role oversees all internal audit activity across the company, providing independent, objective assurance and advice to the Board of Directors (via the Audit, Risk and Compliance Committee (ARCC) and senior management on the design adequacy and operating effectiveness of Hippo’s governance,...

CERiS in Fort Worth, Texas is seeking a DRG Quality Control/Clinical Auditor. The Diagnostic Related Groups (DRG) QC Clinical Auditor will be responsible for performing quality control DRG validation (clinical/coding) reviews of internal audit team reviews of medical records and/or other documentation to determine correct DRG/coding that is clinically supported as defined by review methodologies specific to the contract for which review services are being provided. This involves completing medical records review, accurately documenting findings and non-findings and providing clinical/policy/regulatory support for the determination, as well as communicating missed or incorrect information to the auditors in a professional manner. Experience using, ICD-10-CM & PCS coding guidelines, the ability to understand modern pharmacology, disease management and clinical intervention procedures. This is a remote position. Job Duties and Responsibilities: The Quality Control...

The hospital bill audit nurse supervisor will maintain a positive team building approach with emphasis on overseeing the day to day functions of hospital bill audit nurses, reporting, leadership and professional communication with all CERiS departments.  This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Utilize nursing education, experience and industry best practices to lead a team of registered nurses to plan, execute and deliver timely and accurate hospital bill audits Ensure accuracy of audits through acquired knowledge of client policies, provider contract information, and other standard guidelines Assist in the development and support of auditors to meet and exceed productivity requirements based on CERiS productivity standards Act as a point of contact to answer and resolve auditor issues with the goal of providing excellent customer service and relationship management  Perform audits as necessary Keep manager informed of any issues...

CERIS is seeking a DRG Coder/Clinical Auditor. The Diagnostic Related Groups (DRG) Clinical Auditor will be responsible for performing DRG validation (clinical/coding) reviews of medical records and/or other documentation to determine correct DRG/coding and clinically supported as defined by review methodologies specific to the type of review. This involves completing medical records review, accurately documenting findings and non-findings and providing clinical/policy/regulatory support for the determination. Experience using ICD-10-CM & PCS coding guidelines, the ability to understand modern pharmacology, disease management and clinical intervention procedures.  The ideal DRG Clinical Auditor candidate will have strong oral and written communication skills, clinical knowledge of disease process, and knowledge of medical necessity rules. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: The Clinical Auditor will review medical records to...

The Diagnostic Related Groups (DRG) Clinical Auditor will be responsible for performing DRG validation (clinical/coding) reviews of medical records and/or other documentation to determine correct DRG/coding and clinically supported as defined by review methodologies specific to the type of review. This involves completing medical records review, accurately documenting findings and non-findings and providing clinical/policy/regulatory support for the determination. Experience using ICD-10-CM & PCS coding guidelines, the ability to understand modern pharmacology, disease management and clinical intervention procedures.  The ideal DRG Clinical Auditor candidate will have strong oral and written communication skills, clinical knowledge of disease process, and knowledge of medical necessity rules. This is a remote position.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: The Clinical Auditor will review medical records to determine accuracy of billing through...

Description Job Summary The Treasury Management Service & Onboarding Team Lead is a senior‑level role responsible for leading a team of Treasury Management Service Specialists while also serving as a subject‑matter expert and senior escalation point for complex onboarding, implementation, and servicing activities. The Team Lead oversees day‑to‑day execution, queue health, and service quality; leads complex and high‑impact initiatives; and is accountable for colleague performance, coaching, and development. The Team Lead partners closely with Relationship Managers, Treasury Sales, Operations, Technology, Risk, Legal, and Product teams to ensure predictable delivery, strong risk discipline, and an excellent client experience. Hours: 8-5pm PST Pacific Standard Time Monday - Friday Key Responsibilities Client Onboarding & Implementation Leadership Lead end‑to‑end onboarding, implementation, and...

Higginbotham , a privately held, independent insurance and financial services firm that ranks within the top 20 nationwide, has an immediate opening for a Sr . Employee Benefits Account Coordinator  for our North Texas   office. The  Employee Benefits Account Coordinator provides administrative support to internal account managers and maintains a professional relationship with our external clients. This role will support the worksite clients only. Essential Tasks: Conducts data entry into Excel spreadsheets, internal agency management system, carrier websites, House Bill requests Assists in marketing of accounts as directed by account managers Assists with the preparation of reports, proposals and other presentation materials Audits billing statements for accuracy on behalf of clients Generates open enrollment materials such as enrollment guides, election forms, personalized confirmation sheets, enrollment/change forms, etc. Assists in processing necessary...

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. The Opportunity As a Business Risk and Controls Advisor Senior, you will operate in the first line of defense, ensuring the effectiveness of risk and compliance management programs, risk analytics, and business operations. This role partners closely with Compliance and Risk Management, as well as Business Operations, IT, Audit Services, and Regulators to advance key risk- and compliance-driven initiatives. You will support business leaders in adhering to the established risk framework and provide ongoing oversight of business...

Position Summary: The Commercial Lines Client Service Manager   is responsible for assisting producers and clients in maintaining insurance coverage for commercial lines of insurance to include processing and invoicing policies, endorsements, audits, and cancellations. Supervisory Responsibilities: None Essential Tasks: Prepare endorsement requests to send to insurance carriers Follow-up on receipt of endorsements to existing policies Processing endorsements, including invoicing and delivery to client Processing of audits, including verification of rates, exposures, and prior premiums Handling/processing of cancellations and billing issues Communication with staff and clients as needed to gather needed information for changes to policies Knowledge of and adherence to, agency procedures Provide technical support to Marketing Executives and Producers as needed Establish and maintain relationships with both internal and external clients Core...

The Payment Integrity Analyst is responsible for accurately reviewing and completing pre- and post pay claim audits based on client, policy, industry standards and/or CMS guidelines.   ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Reviews, analyzes, and completes internal audits and/or appeals in accordance with client policy, CMS guidelines and industry standards in clear and professional written communication Use clinical judgement to appropriately interpret and apply client policies along with CMS guidelines as it relates to reviews done by CERIS such as itemized bill, DRG and/or specialty audits Utilize applicable tools and resources to complete internal audits and/or appeals Timely completion of internal audits and/or appeals Attends clinical team meetings, company meetings, educational opportunities/trainings, and other meetings Additional duties as assigned   KNOWLEDGE & SKILLS: Ability to use clinical judgment and analytical skills for...

The Payment Integrity Supervisor is responsible for the daily activities of payment integrity team related to quality assurance and provider appeals. The Supervisor manages and prioritizes staff daily work assignments necessary to ensure the timely and accurate processing of internal and external requests, interdepartmental quality audits and appeals. Additionally, the supervisor works to reduce response timeframes and mitigate future inquiries or escalations by being proactive, taking ownership of challenges, and formulating solutions to improve overall department activities while maintaining a focus on improving how we deliver service to our customers.  This is a remote position. ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: Supervises all daily activities of payment integrity team related to quality assurance and provider appeals Ability to assist team with problem-solving, payer policy and clinical questions regarding audits performed by CERIS Ability to...

Role Details Job Title: Senior Manager, Investment Accounting Location: Houston, TX (Hybrid 4:1) Reports To: VP, Corporate Controller Employment Type: Full time About Us Help us insure it. Tokio Marine HCC is a leading global specialty insurance group, backed by the strength and stability of the Tokio Marine Group. With more than 50 years of sustained growth and profitability, and offices across the United States, the United Kingdom, Europe, and other international locations, we offer more than 100 classes of specialty insurance—covering everything from the crops that feed us and the concerts that entertain us to rescuing travelers abroad. Guided by our Mind Over Risk philosophy, we empower clients to pursue opportunities with confidence while fostering a culture rooted in innovation, collaboration, and trust. Always Advancing, we embrace an entrepreneurial spirit; as Experts in Tomorrow, we anticipate what’s next; and by Reaching Out, we build genuine connections...

The Revenue Cycle Specialist is responsible for analysis and monitoring of claims audit data across multiple platforms. Performs various follow-up activities to ensure the accuracy and appropriateness of reimbursement made to healthcare providers. Responsibilities include identifying payment variances and working internally and externally to resolve such issues. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Analyze and adjust/reprice claims to ensure accurate reimbursement rates in accordance with contractual agreements and payer guidelines Establishing and maintaining accurate pricing structures and rules to ensure competitive and profitable pricing strategies across various claims  with precision Identifies errors in reconciliation files across multiple work streams and business units for multiple sites and with external partners. Performs contract and reimbursement variance analysis. Analyzes claims data to identify...

Job Title: Vulnerability Manager  - Contract to Hire Location: Houston, TX (Hybrid – 4 days onsite / 1 day remote) Job Summary We are seeking a proactive, detail-oriented Vulnerability Manager to lead our enterprise vulnerability management program. This role is responsible for identifying, assessing, prioritizing, and coordinating the remediation of security vulnerabilities across the organization’s IT infrastructure, applications, and cloud environments. The ideal candidate will possess a strong technical background in cybersecurity and a passion for improving the organization’s security posture through continuous risk reduction and operational excellence .   Key Responsibilities Develop and manage the enterprise vulnerability management lifecycle, including scanning, assessment, reporting, and remediation tracking. Conduct regular vulnerability scans using tools such as Qualys, Tenable, or similar platforms. Analyze scan results ,...

Why GMF Technology? Innovation isn’t just a talking point at GM Financial, it’s how we operate. From generative AI and cloud-native technologies to peer-led learning and hackathons, our tech teams are building real solutions that make a difference. We’re committed to AI-powered transformation, using advanced machine learning and automation to help us reimagine customer interactions and modernize operations, positioning GM Financial as a leader in digital innovation within a dynamic industry. Join us and discover a workplace where your ideas matter, your development is prioritized, and you can truly make a global impact. About this role: The Data Engineer III designs, constructs, tests, and maintains highly scalable data management systems. Data Engineer III is responsible for developing complex data pipelines and ensuring data quality, which involves transforming raw data into a form that can be easily analyzed. What makes you an ideal candidate:  Design and build...

Why GM Financial Technology? GM Financial is set to change the auto finance industry and is leading the path with embarking on tech modernization – we have a startup mindset, preserve our small company culture, in a public company environment with financial stability and intense growth over a decade long history. We are data junkies and trust in data and insights to advance our business objectives.  We take our goal of zero emission, zero collision, zero congestion and zero friction very seriously. We believe as the auto finance market leader we are in the driver seat to lead us in the GM EV mission to change the world. We are building global platforms, LATAM, Europe, China – our high performing talent needs a high performing leader. GMF is comprised of over 10,000 team members globally. Join our fin-tech culture within a Blue-Chip company where we are changing the way we use technology to support our customer and business. About the Role: The Senior Technical Principal...

Position Summary:  The Commercial Lines Client Service Manager   is responsible for assisting producers and clients in maintaining insurance coverage for commercial lines of insurance to include processing and invoicing policies, endorsements, audits, and cancellations. Supervisory Responsibilities: None Essential Tasks: Prepare endorsement requests to send to insurance carriers Follow-up on receipt of endorsements to existing policies Processing endorsements, including invoicing and delivery to client Processing of audits, including verification of rates, exposures, and prior premiums Handling/processing of cancellations and billing issues Communication with staff and clients as needed to gather needed information for changes to policies Knowledge of and adherence to, agency procedures Provide technical support to Marketing Executives and Producers as needed Establish and maintain relationships with both internal and external clients Core...

Job Title:  Senior Tax Analyst Location:   Houston, TX | Hybrid  4:1 Reports To: Tax Manager Employment Type: Full-Time Job Summary Under general supervision, maintains tax records and prepares and reviews federal and state income tax returns, estimated tax computations, tax accruals, federal and state tax true-up computations, and related schedules and reports for large consolidated multinational group of entities. Responds to state and IRS notices, information document requests, and completes special projects as requested. Key Responsibilities Prepare and review federal and state income tax returns and quarterly tax estimates, utilizing federal tax compliance guidelines for insurance and international tax areas. Prepare and review quarterly and annual Generally Accepted Accounting Principles (GAAP) and statutory tax accruals and return-to-accrual true-up computations. Respond to notices and audit inquiries from the IRS...