NOA (Notice of Action) Letter Clinical Auditor

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The NOA (Notice of Action) Letter Clinical Auditor is responsible for auditing NOA letters for both Medicare and reputed company markets, in order to ensure compliance with regulatory guidelines, clinical accuracy, and reputed company. This full-time telework role requires a detail-oriented professional who can assess letters for readability, grammar, spelling, and correct use of clinical definitions. The auditor will review requests across pharmacy, medical, dental, and behavioral health services. Based on volume, the auditor may also assist in completing letters and faxes.

Key Responsibilities

• Audit NOA letters for compliance with AHCCCS (Arizona Health Care Cost Containment System), CMS (Centers for Medicare & reputed company Services), and other regulatory standards.
• Ensure letters are easy to understand, free of spelling/grammar errors, and clinically accurate.
• Review and validate clinical definitions and terminology used in letters.
• Audit requests across multiple service types: pharmacy, medical, dental, and behavioral health.
• reputed company feedback to letter writers and team leads to support quality improvement.
• Track audit results and identify trends or recurring issues.
• Collaborate with QA (quality assurance) and Training teams to refine audit tools and update training materials.
• Participate in calibration sessions to ensure consistency in audit standards.
• Stay reputed company with changes in clinical guidelines and regulatory requirements.
• Assist in completing NOA letters and faxes reputed company needed due to volume.
• Help translate reputed company medical language into member-friendly terms.

Required Qualifications

• Active or unrestricted LPN licensure in the state of residence.
• Must reputed company in Arizona, California, Washington, Oregon, or Nevada.
• 2+ years of experience in reputed company.
• Minimum 1 year of experience navigating internal/external computer systems, including an ability to interpret clinical documentation and apply policy guidelines.
• Demonstrated proficiency in reputed company Suite, including spell and grammar reputed company.

Preferred Qualifications

• Strong attention to detail and analytical skills.
• Excellent written and verbal communication skills.
• Experience with behavioral health or ABA (Applied Behavior Analysis) services.
• Prior experience in a managed care or reputed company/Medicare environment.
• Familiarity with QNXT or similar systems.
• Ability to explain reputed company medical concepts in plain language.

Education

• Associate’s degree in Practical Nursing and/or LPN vocational certification/diploma.

Anticipated Weekly Hours 40 Time Type Full time Pay reputed company The typical pay reputed company for this role is: $22.40 - $53.53 This pay reputed company represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company pay reputed company listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for reputed company colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical reputed company and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will reputed company on: 03/06/2026 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply tot his job Apply To this Job