Auditor, Clinical Services
$29.05 - $56.64/hr
... Act (HIPAA), and professionalism in all communications. • Adheres to departmental standards, policies and protocols. • Maintains detailed records of auditing results. • Assists healthcare ...
$29.05 - $56.64/hr
... Act (HIPAA), and professionalism in all communications. • Adheres to departmental standards, policies and protocols. • Maintains detailed records of auditing results. • Assists healthcare ...
$29.05 - $56.64/hr
... Act (HIPAA), and professionalism in all communications. • Adheres to departmental standards, policies and protocols. • Maintains detailed records of auditing results. • Assists healthcare ...
$29.05 - $56.64/hr
... Act (HIPAA), and professionalism in all communications. • Adheres to departmental standards, policies and protocols. • Maintains detailed records of auditing results. • Assists healthcare ...
$29.05 - $56.64/hr
... Act (HIPAA), and professionalism in all communications. • Adheres to departmental standards, policies and protocols. • Maintains detailed records of auditing results. • Assists healthcare ...
Fort Wayne, IN · On-site
$50K - $60K/yr
We are seeking a Compliance Auditor that is MOTIVATED to work for a company with an EVOLVING ... all HIPAA regulations. 8. Always follow Residents' Rights policies. 9. Adhere to all company ...
Quick apply
Fort Wayne, IN · On-site
$50K - $60K/yr
We are seeking a Compliance Auditor that is MOTIVATED to work for a company with an EVOLVING ... all HIPAA regulations. 8. Always follow Residents' Rights policies. 9. Adhere to all company ...
$29.05 - $56.64/hr
... Act (HIPAA), and professionalism in all communications. • Adheres to departmental standards, policies and protocols. • Maintains detailed records of auditing results. • Assists healthcare ...
$29.05 - $56.64/hr
... Act (HIPAA), and professionalism in all communications. • Adheres to departmental standards, policies and protocols. • Maintains detailed records of auditing results. • Assists healthcare ...
$29.05 - $56.64/hr
... Act (HIPAA), and professionalism in all communications. • Adheres to departmental standards, policies and protocols. • Maintains detailed records of auditing results. • Assists healthcare ...
$29.05 - $56.64/hr
... Act (HIPAA), and professionalism in all communications. • Adheres to departmental standards, policies and protocols. • Maintains detailed records of auditing results. • Assists healthcare ...
$29.05 - $56.64/hr
... Act (HIPAA), and professionalism in all communications. • Adheres to departmental standards, policies and protocols. • Maintains detailed records of auditing results. • Assists healthcare ...
$29.05 - $56.64/hr
... Act (HIPAA), and professionalism in all communications. • Adheres to departmental standards, policies and protocols. • Maintains detailed records of auditing results. • Assists healthcare ...
$29.05 - $56.64/hr
... Act (HIPAA), and professionalism in all communications. • Adheres to departmental standards, policies and protocols. • Maintains detailed records of auditing results. • Assists healthcare ...
$29.05 - $56.64/hr
... Act (HIPAA), and professionalism in all communications. • Adheres to departmental standards, policies and protocols. • Maintains detailed records of auditing results. • Assists healthcare ...
$29.05 - $56.64/hr
... Act (HIPAA), and professionalism in all communications. • Adheres to departmental standards, policies and protocols. • Maintains detailed records of auditing results. • Assists healthcare ...
$29.05 - $56.64/hr
... Act (HIPAA), and professionalism in all communications. • Adheres to departmental standards, policies and protocols. • Maintains detailed records of auditing results. • Assists healthcare ...
$29.05 - $56.64/hr
... Act (HIPAA), and professionalism in all communications. • Adheres to departmental standards, policies and protocols. • Maintains detailed records of auditing results. • Assists healthcare ...
$29.05 - $56.64/hr
... Act (HIPAA), and professionalism in all communications. • Adheres to departmental standards, policies and protocols. • Maintains detailed records of auditing results. • Assists healthcare ...
$29.05 - $56.64/hr
... Act (HIPAA), and professionalism in all communications. • Adheres to departmental standards, policies and protocols. • Maintains detailed records of auditing results. • Assists healthcare ...
$29.05 - $56.64/hr
... Act (HIPAA), and professionalism in all communications. • Adheres to departmental standards, policies and protocols. • Maintains detailed records of auditing results. • Assists healthcare ...
$29.05 - $56.64/hr
... Act (HIPAA), and professionalism in all communications. • Adheres to departmental standards, policies and protocols. • Maintains detailed records of auditing results. • Assists healthcare ...
$29.05 - $56.64/hr
... Act (HIPAA), and professionalism in all communications. • Adheres to departmental standards, policies and protocols. • Maintains detailed records of auditing results. • Assists healthcare ...
Mendota Heights, MN · On-site +1
Mentors Auditor I and Auditor II level staff by training, coaching, and providing constructive and ... Segregation of Duties Principles, HIPAA, Security and Privacy, CMS requirements, the Noridian ...
Mendota Heights, MN · On-site +1
Mentors Auditor I and Auditor II level staff by training, coaching, and providing constructive and ... Segregation of Duties Principles, HIPAA, Security and Privacy, CMS requirements, the Noridian ...
Mendota Heights, MN · On-site
Mentors Auditor I and Auditor II level staff by training, coaching, and providing constructive and ... Segregation of Duties Principles, HIPAA, Security and Privacy, CMS requirements, the Noridian ...
Mendota Heights, MN · On-site
Mentors Auditor I and Auditor II level staff by training, coaching, and providing constructive and ... Segregation of Duties Principles, HIPAA, Security and Privacy, CMS requirements, the Noridian ...
Fargo, ND · On-site +1
$52K - $78K/yr
Mentors Auditor I and Auditor II level staff by training, coaching, and providing constructive and ... Segregation of Duties Principles, HIPAA, Security and Privacy, CMS requirements, the Noridian ...
Fargo, ND · On-site +1
$52K - $78K/yr
Mentors Auditor I and Auditor II level staff by training, coaching, and providing constructive and ... Segregation of Duties Principles, HIPAA, Security and Privacy, CMS requirements, the Noridian ...
Fargo, ND · On-site
Mentors Auditor I and Auditor II level staff by training, coaching, and providing constructive and ... Segregation of Duties Principles, HIPAA, Security and Privacy, CMS requirements, the Noridian ...
Fargo, ND · On-site
Mentors Auditor I and Auditor II level staff by training, coaching, and providing constructive and ... Segregation of Duties Principles, HIPAA, Security and Privacy, CMS requirements, the Noridian ...
Fargo, ND · On-site +1
Mentors Auditor I and Auditor II level staff by training, coaching, and providing constructive and ... Segregation of Duties Principles, HIPAA, Security and Privacy, CMS requirements, the Noridian ...
Fargo, ND · On-site +1
Mentors Auditor I and Auditor II level staff by training, coaching, and providing constructive and ... Segregation of Duties Principles, HIPAA, Security and Privacy, CMS requirements, the Noridian ...
Fargo, ND · On-site +1
Mentors Auditor I and Auditor II level staff by training, coaching, and providing constructive and ... Segregation of Duties Principles, HIPAA, Security and Privacy, CMS requirements, the Noridian ...
Fargo, ND · On-site +1
Mentors Auditor I and Auditor II level staff by training, coaching, and providing constructive and ... Segregation of Duties Principles, HIPAA, Security and Privacy, CMS requirements, the Noridian ...
Phoenix, AZ · Remote
$32 - $37/hr
Maintain compliance with HIPAA, privacy, security, and regulatory requirements. * Stay current on ... Risk Adjustment Auditing * HCC Coding * ICD-10-CM Coding * Risk Adjustment Programs * Medicare ...
Phoenix, AZ · Remote
$32 - $37/hr
Maintain compliance with HIPAA, privacy, security, and regulatory requirements. * Stay current on ... Risk Adjustment Auditing * HCC Coding * ICD-10-CM Coding * Risk Adjustment Programs * Medicare ...
Madison, WI · On-site
$58K - $96K/yr
... auditing, technical assistance, or program evaluation. • Conducting or reviewing administrative ... including HIPAA. • Training and/or experience conducting HIPAA/privacy breach incident ...
Madison, WI · On-site
$58K - $96K/yr
... auditing, technical assistance, or program evaluation. • Conducting or reviewing administrative ... including HIPAA. • Training and/or experience conducting HIPAA/privacy breach incident ...
San Antonio, TX · On-site
Understanding of regulatory requirements (e.g., GDPR, HIPAA) * Familiarity with penetration testing processes * Knowledge of cloud security auditing * Experience with incident response and forensic ...
San Antonio, TX · On-site
Understanding of regulatory requirements (e.g., GDPR, HIPAA) * Familiarity with penetration testing processes * Knowledge of cloud security auditing * Experience with incident response and forensic ...
$38.5K - $48.7K
3% of jobs
$48.7K - $59K
11% of jobs
$59K - $69.2K
8% of jobs
$72.5K is the 25th percentile. Wages below this are outliers.
$69.2K - $79.4K
11% of jobs
The median wage is $88.3K / yr.
$79.4K - $89.6K
20% of jobs
$89.6K - $99.9K
13% of jobs
$108K is the 75th percentile. Wages above this are outliers.
$99.9K - $110.1K
12% of jobs
$110.1K - $120.3K
11% of jobs
$120.3K - $130.5K
9% of jobs
$130.5K - $140.8K
3% of jobs
$140.8K - $151K
0% of jobs
$38.5K
$92.8K
$151K
HIPAA Auditors often encounter the challenge of staying up-to-date with frequently changing regulations and ensuring that all departments within an organization adhere to compliance standards. They must carefully balance thorough audits with minimal disruption to daily healthcare operations. Additionally, auditors sometimes face resistance or apprehension from staff regarding compliance reviews, making interpersonal and communication skills especially important. Successfully navigating these challenges requires a proactive approach, attention to detail, and a deep understanding of both the regulatory environment and the organizational workflow.
To thrive as a HIPAA Auditor, you need a thorough understanding of healthcare regulations, compliance frameworks, and risk assessment, usually supported by a background in healthcare administration, information security, or compliance. Familiarity with auditing tools, electronic health records (EHR) systems, and certifications such as Certified HIPAA Professional (CHP) or Certified Information Systems Auditor (CISA) is highly valuable. Strong analytical, attention to detail, and effective communication skills set outstanding HIPAA Auditors apart. These competencies are crucial to ensure organizations maintain regulatory compliance and protect sensitive patient information.
A HIPAA Auditor is responsible for evaluating an organization's compliance with the Health Insurance Portability and Accountability Act (HIPAA). They conduct audits, review policies and procedures, assess security measures, and identify potential risks related to protected health information (PHI). Their goal is to ensure that healthcare providers, insurers, and other covered entities follow HIPAA regulations to safeguard patient data. HIPAA Auditors also provide recommendations for improving compliance and may assist with employee training on HIPAA requirements.

$29.05 - $56.64/hr
Full-time
Re-posted 21 days ago
8.0
Based on 198 frontline employees who took The Breakroom Quiz
163rd of 304 rated insurance
JOB DESCRIPTION Job Summary
Provides support for healthcare services clinical auditing activities. Performs audits for clinical functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
• Performs audits in utilization management, care management, member assessment, behavioral health, and/or other clinical teams, and monitors clinical staff for compliance with National Committee for Quality Assurance, Centers for Medicare and Medicaid Services (CMS), and state/federal guidelines and requirements. May also perform non-clinical system and process audits as needed.
• Audits for clinical gaps in care from a medical and/or behavioral health perspective to ensure member needs are being met.
• Assesses clinical staff regarding appropriate clinical decision-making.
• Reports monthly outcomes, identifies areas of re-training for staff, and communicates findings to leadership.
• Ensures auditing approaches follow a Molina standard in approach and tool use.
• Maintains member/provider confidentiality in compliance with the Health Insurance Portability and Accountability Act (HIPAA), and professionalism in all communications.
• Adheres to departmental standards, policies and protocols.
• Maintains detailed records of auditing results.
• Assists healthcare services training team with developing training materials or job aids as needed to address findings in audit results.
• Meets minimum production standards related to clinical auditing.
• May conduct staff trainings as needed. • Communicates with quality and/or healthcare services leadership regarding issues identified, and works collaboratively to subsequently resolve/correct.
Required Qualifications
• At least 2 years health care experience, with at least 1 year experience in utilization management, care management, and/or managed care, or equivalent combination of relevant education and experience.
• Registered Nurse (RN). License must be active and restricted in state of practice.
• Strong attention to detail and organizational skills.
• Strong analytical and problem-solving skills.
• Ability to work in a cross-functional, professional environment.
• Ability to work on a team and independently.
• Excellent verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.
Preferred Qualifications
• Utilization management, care management, behavioral health and/or long-term services and supports (LTSS) clinical review/auditing experience.
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To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $29.05 - $56.64 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.
Health care and social assistance
10,000+ Employees
Long Beach, CA, US
1980