Audit Team Lead jobs in United States
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Optum · 3 hours ago

Audit Team Lead

positionUnited States
timeFull-time
remoteRemote
seniorityMid, Senior Level
money$73K/yr - $130K/yr
date1+ years exp

Optum is focused on improving the flow of health data and information to create a more connected system. The Audit Team Lead will oversee compliance reviews of medical and administrative documentation to identify healthcare fraud and work with a team to ensure adherence to compliance policies.

EducationHealth CareMedicalPharmaceutical
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H1B Sponsor Likelynote

Responsibilities

Supervise and support the work of other Auditors as detailed below
Review medical and administrative records for audit/compliance review
Travel to provider sites up to 25%/month to collect records and engage with providers
Present and participate in discussions with client regarding audit observations and findings
Collaborate with a team of 2-5 auditors to complete reviews
Enter audit findings data and notes in online/electronic platform using Excel-based templates
Attend and participate in dispute reviews and administrative hearings

Qualification

Nurse licensureMedical coder certificationHealthcare documentation reviewExcel data analysisMedical terminology knowledgeClaim coding knowledgeCustomer service skillsWritten communication skillsVerbal communication skills

Required

High School Diploma or GED
Must be 18 years of age OR older
Nurse licensure (RN or LPN) or medical coder certification (CPC or CPMA)
Must be willing to travel up to 25% within the state of Massachusetts
1+ years experience reviewing health care documentation in a clinical or administrative role
1+ years basic experience with Excel, including familiarity with basic formulas and data analysis
Written and verbal communications skills
Customer service skills
Ability to work full time (40 hours/week), Monday - Friday, with flexibility for occasional overtime or weekend needs

Preferred

Clinical or administrative experience in long term care, for example, nursing facility care delivery/administration and/or community-based LTC service programs like Home Health
Familiarity with Medicaid program and/or billing requirements
Working knowledge of medical terminology and claim coding
Experience in claim processing, healthcare provider information, and healthcare billing practices
Familiarity with CPT-4, HCPCs and ICD-10 code terminology
Experience working in a remote/telecommute workspace

Benefits

Comprehensive benefits package
Incentive and recognition programs
Equity stock purchase
401k contribution

Company

Optum

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Optum is a healthcare company that provides pharmacy services, health care operations, and population health management. It is a sub-organization of UnitedHealth Group.
dateFounded in 2011
location
Eden Prairie, Minnesota, USA
people-size10001+ employees
web-link
https://www.optum.com/

H1B Sponsorship

Optum has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (648)
2024 (559)
2023 (620)
2022 (851)
2021 (593)
2020 (438)

Funding

Current Stage
Late Stage

Leadership Team

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Daniel Castillo
Chief Executive Officer, Optum Care Delivery
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J
Jay Green
Chief Financial Officer
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Recent News

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2025-11-07
Company data provided by crunchbase