• Lead Auditor CRS

    UL, LLC (Allentown, PA)
    …one or more scope specific professional credential(s), such as: GFSI recognized auditor credential; CQA, RABQSA, IRCA, RAC , Pharmaceutical GMP Professional ... Lead Auditor - GMP Quality Audits will perform high...report in accordance with UL, industry scheme, and client audit protocols on facilities working and/or operational conditions as… more
    UL, LLC (07/03/25)
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  • Coding Auditor Educator

    Highmark Health (Harrisburg, PA)
    …entities in response to external coding audits conducted by the Medicare Administrative Contractor , the RAC , MIC, ZPIC, etc. Determine appeal action, prepare ... OVERVIEW:** Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and… more
    Highmark Health (07/16/25)
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  • RN Clinical Review Appeals Specialist

    St. Luke's University Health Network (Allentown, PA)
    …and procedure code assignment and MS-DRG/APR-DRG accuracy based on denials or audit findings from government and commercial payers. Meet or exceed established ... the physician advisor in review of patient medical records identified by RAC /MIC/QIO and other governmental or commercial payor auditors in retrospective reviews for… more
    St. Luke's University Health Network (07/08/25)
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  • Auditing & Compliance Director - Software as…

    Wolters Kluwer (Philadelphia, PA)
    …and recommending comprehensive upgrades to prevent future issues . Lead Auditor Certified, preferred . Regulatory Affairs Certification ( RAC ), preferred. ... Kluwer. Important responsibilities include cross-functional correspondence, quality management reviews, audit support, change planning, and corrective and preventative action… more
    Wolters Kluwer (06/11/25)
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