Jobs in the United States

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Data Scientist AI Research & Innovation
TransUnion LLC
Chicago, IL
- $112,500 to $187,500 USD / year
Advanced programming skills in Python and familiarity with modern AI development frameworks
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Director, Threat Management & Investigations
TransUnion LLC
Reston, VA · Chicago, IL · Crum Lynne, PA · NY
- $150,100 to $225,000 USD / year
Build and lead TransUnion’s enterprise-wide Threat Management & Investigations program, establishing scalable processes to identify, monitor, assess, respond to and mitigate threats…
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Corporate Affairs and Communication Senior Advisor
TransUnion LLC
Washington, DC · Chicago, IL
- $126,700 to $190,000 USD / year
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Sr Director, Market Planner
TransUnion LLC
Chicago, IL · NY · Reston, VA · Boca Raton, FL
- $187,500 to $312,500 USD / year
…and collaborate with Global and Insurance Solutions, Market Development, Data Science and Analytics, Sales , and senior vertical…
Added 1 min ago
Pharmacy Student Intern
Albertsons Companies
CHICAGO, IL · Chicago, IL
Pharmacy students currently enrolled in a professional pharmacy program will have the opportunity to concentrate on patient counseling, customer service, over the counter medications,…
Added 2 mins ago
Operations Specialist
CACI, INC.-FEDERAL
Southern Pines, NC
…Emergent Threats, Operations, and Planning Support (SOFETOPS) Program Management at USASOC. You will help drive new requirement processes, organize and implement program methodologies, and…
Added 3 mins ago
Clinical Nursing Student (CNS) - Nursing Float Pool - St. Elizabeth Boardman Hospital - PRN
Bon Secours Mercy Health Inc
Youngstown, OH
Currently enrolled in a nursing program and has completed one clinical nursing course and one clinical rotation (required)
Added 3 mins ago
Clinical Nursing Student - St. Elizabeth Youngstown Hospital - PRN
Bon Secours Mercy Health Inc
Youngstown, OH
Currently enrolled in a nursing program and has completed one clinical nursing course and one clinical rotation (required)
Added 3 mins ago
Patient Care Technician (PCT) - Orthopedics Neurology - Lourdes Hospital
Bon Secours Mercy Health Inc
Paducah, KY
Currently enrolled in or a graduate of an Associate’s or Bachelor’s degree (in any field) with no experience requirement. Must successfully complete the RSF PCT Training Program upon hire.
Added 3 mins ago
Patient Care Technician (PCT) - Progressive Care - Lourdes Hospital
Bon Secours Mercy Health Inc
Paducah, KY
Currently enrolled in or a graduate of an Associate’s or Bachelor’s degree (in any field) with no experience requirement. Must successfully complete the RSF PCT Training Program upon hire.
Added 3 mins ago
Clinical Nursing Student - Progressive Care - Lourdes Hospital - PRN
Bon Secours Mercy Health Inc
Paducah, KY
Currently enrolled in a nursing program and has completed one clinical nursing course and one clinical rotation (required)
Added 3 mins ago
Patient Care Technician (PCT) - Progressive Care - Lourdes Hospital
Bon Secours Mercy Health Inc
Paducah, KY
Currently enrolled in or a graduate of an Associate’s or Bachelor’s degree (in any field) with no experience requirement. Must successfully complete the RSF PCT Training Program upon hire.
Added 3 mins ago
SV
Child Care Assistant Group Supervisor - Part Time - Day Shift - Erie, PA
Saint Vincent Health Center
United States
- Part-time
Associate's Degree from an accredited college or university in early childhood education, child development, or special education and 2 years’ experience with children -OR- relevant…
Added 4 mins ago
SO
Mental Health Professional III/ BPH Adult Civil- Adult Clinical Treatment Services
State of South Carolina
Columbia, SC
- $58,854 to $105,978 USD / year
…Clinical Treatment Services, Under limited supervision of the Program Manager I /ACTS Lead, conducts functional analysis/assessment and implements applied behavior analysis principles for…
Added 5 mins ago
Registered Nurse Med Surg/PT/Nights 12 hr. Shifts
KPC GLOBAL MEDICAL CENTERS INC.
Hemet, CA
Associate Degree in Nursing (ADN) or completion of an accredited Registered Nurse program required.
Added 5 mins ago
Registered Nurse, MDU, Per-Diem Nights
KPC GLOBAL MEDICAL CENTERS INC.
Menifee, CA
Associate Degree in Nursing (ADN) or completion of an accredited Registered Nurse program required.
Added 6 mins ago
Financial Advisor - PNC Wealth Management
PNC Wealth Management LLC
Milford, OH
…keep all parties on the same side of the table. PNC’s referral program and culture drives and encourages teamwork resulting in branch partners having a vested interest in our advisors’…
Added 6 mins ago
Financial Analyst (Associate, Experienced, and/or Senior)
The Boeing Company
Hazelwood, MO
…roles will collectively support the execution of a proprietary development program. Additional details on each position can be found…
Added 6 mins ago
Procurement Financial Analyst (Associate, Experienced or Senior)
Hazelwood, MO
We are seeking talented Procurement Financial Analysts (Associate, Experienced or Senior) to join Boeing’s Defense Procurement Financial Analysis team in Hazelwood, MO.
Added 6 mins ago
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Distribution Center Associate
Cotopaxi
West Valley City, UT
- $18 USD / hour
At Cotopaxi, people are always at the heart of what we do. As a Distribution Center Associate, they/she/he play a vital role in ensuring our gear reaches customers, stores, and wholesale…
Added 6 mins ago
UG
Part-Time Associate Patient Care Coordinator
UnitedHealth Group
Waukesha, WI
- $16 to $29 USD / hour
- Part-time
…together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our…
Added 6 mins ago
Financial Advisor - PNC Wealth Management
PNC
Milford, OH
…keep all parties on the same side of the table. PNC’s referral program and culture drives and encourages teamwork resulting in branch partners having a vested interest in our advisors’…
Added 7 mins ago
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Warehouse Part Time Overnight
Lowes
Los Angeles, CA
- $18.42 to $20.2 USD / hour
- Part-time
…and grow, Lowe’s is ready to support your goals. As a Lowe’s associate, you’ll gain access to many benefits beyond competitive pay and flexible…
Added 7 mins ago
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Retail Sales – Part Time
Lowes
Kahului, HI
- $17.5 to $19.6 USD / hour
- Part-time
As a Customer Service Associate, you combine top-notch customer service skills with genuine care for people to help customers feel comfortable while shopping at Lowe's. This is an excellent…
Added 7 mins ago
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Retail Sales – Part Time
Lowes
Franklin, VA
- Part-time
As a Customer Service Associate, you combine top-notch customer service skills with genuine care for people to help customers feel comfortable while shopping at Lowe's. This is an excellent…

Wayspring

Chart Auditor

Nashville, TN, United States

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Job details

Experience: 3+ years of clinical experience in behavioral health and 2+ years in utilization review, chart audit, medical record review or payer-side clinical review.
Posting language: English

Original job description

Chart Auditor Overview

Our chart auditors perform pre-payment and post-payment reviews of behavioral health records on behalf of health plan customers, confirming that services are medically necessary, clearly documented and billed correctly. We are running selective post-payment review pilots today and preparing to launch pre-payment review, so this is a chance to help shape a service as it scales.

As a Chart Auditor, you will pair your behavioral health clinical expertise with an AI-assisted review platform, working under the guidance of Wayspring's clinical leadership, including an Associate Medical Director who oversees rubric development and clinical review. Your findings will directly shape the rubrics, policies and tools that make our reviews faster, more consistent and more defensible as we expand to additional health plan customers.

Why Wayspring?

We are passionate about breaking barriers alongside those with complex behavioral health needs. Whether you’re in the field or in the corporate office – our mission is felt, and your impact is recognized. There is no inner circle, and we all have a seat at the table. Leaders are accessible and silos are avoided. We respect your craft and love to be challenged. We invest not only in our mission, but in each other. Internal promotions and cross departmental training are the norm – you grow, we grow.

Responsibilities of Chart Auditor

Clinical Chart Review

Conduct pre-payment and post-payment clinical reviews of complex behavioral health medical records against Wayspring policies and rubrics, ASAM criteria, CMS and state Medicaid requirements, health plan policy and other national practice guidelines.
Assess medical necessity, documentation sufficiency and level of care, and confirm that coding and billing align with the services documented.
Document clear, defensible findings and rationale for every review and manage appeals, as needed.
Meet established productivity, accuracy, and turnaround targets.

Quality & Calibration

Participate in inter-rater reliability exercises and quality assurance calibration sessions to keep review decisions consistent across the team.
Escalate complex or ambiguous cases to physician reviewers or the Medical Director.
Identify trends such as provider billing patterns, documentation gaps and potential fraud, waste and abuse for reporting.

Tools, Rubrics & Continuous Improvement

Use an AI-assisted review platform daily, validating and correcting AI-generated outputs.
Provide structured feedback that improves the accuracy and usability of review tools.
Participate in ongoing education and training sessions with clinical leaders to build proficiency in specialized and emerging behavioral health concepts relevant to chart review.
Recommend refinements to review rubrics and policy content based on what you observe in the charts.

Required Qualifications

Active CPC, CCS, CCS-P, CPMA, or comparable nationally recognized medical coding/auditing certification required.
3+ years of clinical experience in behavioral health and 2+ years in utilization review, chart audit, medical record review or payer-side clinical review.
Working knowledge of ASAM Criteria and/or other evidence-based behavioral health medical necessity and level-of-care criteria, with the ability to quickly learn and apply payer-specific clinical guidelines.
Strong written communication, with the ability to document concise, defensible clinical rationale.
Comfort learning and working in new technology, including web-based and AI-assisted tools.

Preferred Qualifications

Experience with Medicaid managed care.
Familiarity with CPT and HCPCS coding and behavioral health billing practices.
Professional certification such as CPC, CCS, CPMA, CPUR or CCM.
Experience using AI-assisted or software-based clinical review tools.
Background in fraud, waste and abuse, payment integrity or special investigations (SIU).
Experience in a startup or fast-growing organization.

Our goal is to foster a workplace where everyone feels a true sense of belonging, is supported, and empowered to thrive. We actively seek different backgrounds, perspectives, and experiences - because we believe that drives better performance and innovation. We’re committed to identifying and removing barriers for the communities we serve.

Benefit Summary

Creating a great employee experience takes more than just perks - but let’s be real, those matter too. Here’s how we’re building a company where you, your family, your pets, and your passions can thrive.

Comprehensive Medical, Dental and Vision Insurance options – including options for your pets!
Company funded HSA + Monthly Gym Allowance
Paid parental leave – all parents included!
Company paid short term disability, long term disability and life insurance
401k with company match
Premium Employee Assistance Program, inclusive of counseling sessions
Pardon and Expungement Scholarship Program
Company Contributions to Future Minded Savings (HSA and Emergency savings fund)
Generous PTO package (accrual policy based on years of service) and an additional 10 paid company holidays
Company 2 week paid sabbatical program!

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