medical records auditor

Rising Medical Solutions

<div>
 Have you ever looked a medical bill and immediately noticed something was wrong? Were you itching to use your expertise to fix it? We've been there, too. In fact, that's how our business was born - and continues to thrive. Rising Medical Solutions is looking for a Nurse Auditor who wants to make their mark in the world of medical cost containment.
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 Join our team and maximize client savings by reviewing medical bills from a nurse perspective, including appropriate billing, coding and treatment, fee schedule compliance, over-utilization, and erroneous charges. We pride ourselves on outstanding customer service and work hard to keep our impeccable reputation in the industry.
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 In this role, you'll be a part of our mission by giving clients the information they need to determine case value based on evaluation of medical records and medical billing statements, and will:
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   Audit medical and billing records to determine if services provided are reasonable, appropriate and necessary
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   Clinically identify and evaluate any charges not related to the occurrence
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   Verify that charges are in accordance with the services ordered and authorized
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   Initiate appropriate contacts with clients and medical providers as appropriate and necessary
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   Negotiate bills and conduct re-evaluation reviews as required
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 All while maintaining a human touch, demonstrating sensitivity to culturally-diverse people and situations.
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 <strong>
  Requirements
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 <ul>
  <li>
   RN (or LPN) with active professional license or equivalent within states of operation
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   CPC and/or CPC-H certification(s) strongly desired
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   Specialized training in hospital coding, ortho, neuro, rehab, or ER procedures
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   3-5 years of clinical experience in acute care, surgery and/or orthopedic
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   Workers' Compensation medical bill review experience a major plus
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   Understanding of CPT and ICD-10 codes and Medicare guidelines
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   Ability to apply knowledge to state fee schedules
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   A customer service orientation, including strong communication skills
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   Experience in any deposition or litigation cases a plus
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  </li>
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  Benefits
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   Competitive benefits package, including health insurance, 401(k) with company match, paid time off, paid holidays, and more
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   Flexible hybrid schedule with in-office days reserved for training and collaborative meetings
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   Employment within a firm committed to core values, staff development, emerging technology, private ownership, and controlled growth/reinvestment in the future - we frequently promote from within!
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   Opportunity to make a difference in reducing health care costs and increasing the value of health care to individuals and their employers
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   A relaxed, yet upbeat work environment
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   And for those in the office: casual dress code with unlimited coffee!
  </li>
 </ul>
</div>


Nurse Auditor - Medical Bill Review (Remote)

Alignment Healthcare

<div><p>Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.</p><p></p>
This is a remote position.<br>
The MRA Coding Auditor supports departmental Quality Assessment audits of internal Coding Analyst team and vendors to ensure accurate and complete data is submitted to CMS. Assists in Risk Adjustment related data audits (RAF, prevalence, clinical documentation improvement, P360, process) audits to identify areas of opportunity for improvement (training, data integrity, chart reviews).<p></p><p><b>
GENERAL DUTIES/RESPONSIBILITIES:</b><br>
1. Supports regular quality assurance (QA) audits of internal Coding Analyst Team to validate and confirm coding &amp; abstracting quality (95% HCC accuracy). These ongoing audits ensure coding quality &amp; performance improvement standards are maintained, achieved &amp; improved per department policies and procedures.<br>
2. Tracks and reports progress of QA audits performed on the coding vendors to verify the coding accuracy and quality of the data submitted to AHP is accurate for submission to CMS.<br>
3. Works with Risk Adjustment Management on any MRA data validation / coding audit to ensure completeness and coding accuracy of all submissions to CMS. This work may encompass reviews of data for reconciliation, data flow integrity, UAT testing, high cost / low risk score members, retrospective chart reviews, or other risk adjustment related data review as directed by Manager.<br>
4. Analyzes and shares audit results with Manager. This information may be used for training physicians and clinical staff, documentation improvement, and system / process improvement.<br>
5. Utilizes, protects, and discloses Alignment Healthcare patients&rsquo; protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.<br>
6. Ensures compliance with all applicable federal, state &amp;local regulations, as well as with institutional/organizational standards, practices, policies &amp; procedures.</p><p>
7. Maintains professional / technical knowledge by attending appropriate educational workshops; reviewing professional publications; establishing personal networks; and participating in professional societies. Stay current of industry coding, compliance, and HCC issues. Required to maintain relevant continuing education units (CEUs) in relation to individual coding certifications.<br>
8. Other duties as assigned to meet the organization&rsquo;s needs.</p><p><b>
Job Requirements:</b></p><p><b>
Experience:</b></p><ul><li>Required: Minimum three years of Medicare Risk Adjustment coding in a medical group or health plan setting required</li><li>Preferred:</li></ul><p><b>
Education:</b></p><ul><li>Required: High School Diploma or GED. Completion of a Medical Coding training program.</li><li>Preferred: Bachelor&rsquo;s degree in Business Administration, health Care Management or in a related field</li></ul><p><b>
Training:</b></p><ul><li>Required: Technical School or courses that are required to become a certified coder.</li></ul><p><b>
Specialized Skills:</b></p><ul><li>Required:</li></ul><ul><li>
Knowledge of</li><li>
Proficient user in MS office suite &ndash; Excel, Word, Outlook</li><li>
Previous use of Epic, Allscripts, EZCap</li><li>
Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.</li><li>
Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors;</li><li>
Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly</li><li>
Reasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution.</li><li>
Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment.</li><li>
Report Analysis Skills: Comprehend and analyze statistical reports.</li></ul><p><b>
Licensure:</b></p><ul><li>Required: Certified Coder required, CCS, CCS-P, CPC, or CRC</li></ul><p>
Work Environment:</p><p>
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</p><p>
Essential Physical Functions:</p><p>
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</p><p></p><p>
1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.</p><p>
2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.</p>
Pay Range: $64,384.00 - $96,577.00<p>
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
</p><p></p><p>Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.</p><p></p><ul><li><i>DISCLAIMER: Please</i><i> beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal </i><i>information. Please</i><i> be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at </i><i>https://reportfraud.ftc.gov/#/</i><i>. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health&rsquo;s talent acquisition team, please email </i><i>careers@ahcusa.com</i><i>.</i></li></ul></div>

MRA Coding Auditor - Remote

CCE Contracting & Construction Enterprises

<p>Key Responsibilities</p><ul><li>Develop and implement internal QA/QC audit plans and schedules.</li><li>Conduct periodic internal audits of quality management systems, processes, and project activities.</li><li>Verify compliance with approved quality plans, procedures, specifications, and contractual requirements.</li><li>Review quality records, inspection reports, test reports, material approvals, and non-conformance reports (NCRs).</li><li>Identify non-conformities, observations, and opportunities for improvement.</li><li>Prepare detailed audit reports and communicate findings to management and relevant stakeholders.</li><li>Monitor and verify the implementation and effectiveness of corrective and preventive actions.</li><li>Ensure compliance with applicable quality standards and organizational procedures.</li><li>Maintain audit records and documentation in accordance with established requirements.</li><li>Provide recommendations to enhance quality performance and continuous improvement.</li><li>Participate in management reviews and quality performance assessments as required.</li></ul><p>Minimum Qualifications</p><ul><li>Bachelor&rsquo;s Degree in Engineering, Quality Management, or a related discipline.</li><li>Certified Internal Auditor or ISO 9001 Internal Auditor/Lead Auditor certification.</li><li>Additional quality management certifications are preferred.</li></ul><p>Experience Requirements</p><ul><li>Minimum 10 years of experience in QA/QC auditing.</li><li>Proven experience auditing infrastructure and construction projects.</li><li>Experience in implementing and auditing Quality Management Systems.</li><li>Familiarity with contractor and consultant quality assurance processes.</li></ul><p>Skills &amp; Competencies</p><ul><li>Strong knowledge of Quality Management Systems (QMS) and ISO 9001 requirements.</li><li>Excellent auditing, analytical, and problem-solving skills.</li><li>Ability to prepare professional audit reports and technical documentation.</li><li>Strong communication and interpersonal skills.</li><li>Ability to work independently and maintain objectivity and confidentiality.</li><li>Proficiency in Microsoft Office applications and document control systems.</li></ul><p>Reporting</p><ul><li>Reports audit findings, recommendations, and compliance status to project management and relevant stakeholders.</li><li>Supports management in ensuring continual improvement and compliance with quality requirements.</li></ul><p>Application Question(s):</p><ul><li>Your current location?</li><li>Are you able to relocate?</li><li>Are you working currently?</li><li>Your current salary?</li><li>Expected salary?</li><li>Is your Iqama valid?</li><li>Notice period (when you can join?)</li></ul><p>Work Location: In person</p>

Registered Internal Auditor (QA/QC)

Midas Hospitality

<div><p><b>Night Auditor- TownePlace Suites: Wentzville, MO</b></p><p><b><br>
Midas Hospitality is recognized as one of the Top 100 U.S. Employers in 2021 (by MogulRecruiter). Ranking #30 for talent, #13 for diversity, #33 for best in minorities, #16 for blacks and #11 for women.</b></p><p><b><br>
Start Your Journey with Midas Hospitality:
</b></p><p>Midas Hospitality is seeking a full-time Night Auditor to join our team at the TownePlace Suites hotel located in Wentzville, MO. This position will reconcile all business transactions at the hotel as well as check-in and resolve any guest problems.</p><p><b><br>
What You Will Be Doing</b><b>:</b></p><ul><li>
Greets, registers, and assigns rooms to guests. Issues room key and gives directions.</li><li>
Keeps records of room availability and guests' accounts</li><li>
Ensures all paperwork is completed from the Front Desk and F&amp;B computer systems.</li><li>
Closes out the day for both the Front Desk and F&amp;B computer systems.</li><li>
Runs reports for the previous day's business.</li><li>
Makes, confirms, and cancels reservations</li><li>
Handles accounting of money, receipts, guest accounts and credit through operation of the FD computer system and completion of reports required to ensure company funds are secure.</li></ul><p><b><br>
The Ideal Candidate:</b></p><ul><li>
One year cash handling experience</li><li>
One year experience at a Front Desk position (in a hotel)</li><li>
Ability to work nights and weekends</li></ul><p><br>
We offer a range of benefits including, but not limited to:</p><ul><li>
Growth and development tools and access to learning</li><li>
Robust PTO policies</li><li>
Medical/Dental/Vision Coverage</li><li>
401k matching</li><li>
Employee Assistance Program
</li><li>Discounted products and services</li></ul><p><b>
About Us:</b></p><p>
From humble beginnings in 2006 to an enterprise being driven by more than 1,000 people today, Midas Hospitality has never lost sight of our #1 priority - people. Currently, Midas Hospitality operates 40+ hotels in 14 states with a focus on select-service and extended-stay properties for leading brands such as Marriott, Hilton and IHG. At Midas Hospitality, <b><i>we make room for people's dreams</i></b>. That means building a company where people love to work, our financial partners love the results and everyone loves the experience.
</p><p>As a people-first organization, we offer opportunities to grow and benefits to flourish for anyone with a desire to serve others and a tremendous work ethic. We aim to competitively compensate our associates and reward their contributions.
</p><p>Please visit our website for more information: www.midashospitality.com<br>
</p><br>
<p>Midas Hospitality is proud to be a drug free workplace and equal opportunity employer.</p></div>

Night Auditor

Johns Hopkins Aramco Healthcare

<div></div><div><div><div><div><div><div><div><div><h2 class="jobSectionHeader"><b>Job Title</b></h2>
</div><div>ASSOCIATE AUDITOR.</div></div><div><div><h2 class="jobSectionHeader"><b>
Job Family</b></h2>
</div></div><div></div><div><div><h2 class="jobSectionHeader"><b>Function</b></h2>
</div><div>CIA</div></div><div><div><h2 class="jobSectionHeader"><b>
Job Code</b></h2>
</div><div>30008733</div></div><div><div><h2 class="jobSectionHeader"><b>
Reports to Job</b></h2>
</div><div>Internal Audit Manager</div></div><div><div><h2 class="jobSectionHeader"><b>
Job Description Summary</b></h2>
</div><div>The Associate Auditor assists in completing assigned audits at any location, adhering to the IIA Ethics AND Professionalism Standards, to ensure compliance with internal policies and external regulations and thereby maintain the organization's IT, financial, and operational integrity.</div></div><div><div><h2 class="jobSectionHeader"><b>
Strategic Roles &amp; Responsibilities %</b></h2>
</div><div>5</div></div><div><div><h2 class="jobSectionHeader"><b>
Strategic Roles &amp; Responsibilities</b></h2>
</div><div><ul><li>Assist in evaluating controls built into the process within the assigned area using knowledge of business systems and appropriate auditing techniques Assist in assessing risks associated with operational IT and financial objectives aligned to organizational goalsProvide necessary support to the InCharge Auditor to complete the audit within the allotted time while providing necessary assurance</li></ul></div></div><div><div><h2 class="jobSectionHeader"><b>
Operational Roles &amp; Responsibilities %</b></h2>
</div><div>95</div></div><div><div><h2 class="jobSectionHeader"><b>
Operational Roles &amp; Responsibilities</b></h2>
</div><div><ul><li>Assist in understanding the auditable area by identifying risks and helping prepare the planning memorandum and audit program</li><li>
Perform detailed IT financial and operational systems analysis of assigned areassteps and document findings ensuring accuracy and completeness</li><li>
Prepare audit field memorandums and communicate findings to the audit client recommending corrective actions to improve operations and reduce costs</li><li>
Participate in audit closing meetings and contribute to finalizing audit reports</li></ul></div></div><div><div><h2 class="jobSectionHeader"><b>
Minimum Education Required</b></h2>
</div><div>Bachelor's Degree in Accounting, Finance, Computer Science, medical or another relevant business related field</div></div><div><div><h2 class="jobSectionHeader"><b>
Professional Certifications Required</b></h2>
</div><div>CHIAP, CIA, CISA, CFE or other relevant professional certification such as CPA, ACCA, or CMA is preferred.</div></div><div><div><h2 class="jobSectionHeader"><b>
Years of Experience</b></h2>
</div><div>Up to 2 years experience in auditing or related field.</div></div><div><div><h2 class="jobSectionHeader"><b>
Languages</b></h2>
</div><div>English:Advanced ; Arabic:Advanced</div></div><div><div><h2 class="jobSectionHeader"><b>
Functional Competencies</b></h2>
</div><div><ul><li>Due Diligence</li><li>
Audit Reporting</li><li>
Data Collection</li></ul></div></div><div><div><h2 class="jobSectionHeader"><b>
Core Competencies</b></h2>
</div><div><ul><li>Excellence</li><li>
Integrity</li><li>
Accountability</li><li>
Cybersecurity</li><li>
Person-Centered Care</li></ul></div></div><div><div><h2 class="jobSectionHeader"><b>
Acknowledgement</b></h2>
</div><div>Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.</div></div><div><div><h2 class="jobSectionHeader"><b>
Addendum Title</b></h2>
</div><div>No</div></div><div><div><h2 class="jobSectionHeader"><b>
Supplemental Work/Experience/Education Information</b></h2>
</div><div>N/A</div></div><div><div><h2 class="jobSectionHeader"><b>
Addendum Description</b></h2>
</div><div>N/A</div></div></div></div></div></div></div></div><p></p>

ASSOCIATE AUDITOR.

State of Ohio

<p></p><div><div><div>The Auditor of State&rsquo;s office (AOS) is looking for accounting professionals in or within close proximity to <b>Tuscarawas County </b>to fill an external financial audit vacancy. Auditors for the office ensure that taxpayer dollars are being utilized by public entities according to the letter of the law. AOS staff work in small team environments performing financial statement and administrative controls testing on government clients. These clients will include, but are not limited to cities, villages, and schools. We are looking for individuals with an <b>accounting education and/or experience.</b></div><div></div><div><b><br>
What You'll Do:</b></div><ul><li>
Develop working knowledge of auditing techniques, Ohio State government, professional auditing standards, and State fiscal practices.</li><li>
Serve as a contributing member of an audit team, completing assigned duties of limited scope and communicate with the team leader concerning proper methods to be applied in the audit context.</li><li>
Receive controlled assignments of increasing difficulty and responsibility.</li><li>
Conduct background research of agencies being audited, including examination of relevant statutes, rules, and regulations.</li><li>
Travel to audit site locations and obtains audit evidence. Performs audit fieldwork which includes.</li><li>
Visual examination of records and other items and preparation and organization of workpapers showing the results of audit examinations.</li><li>
Learn to gather, interpret, compile, and analyze data pertinent to audits performed by the office.</li><li>
Review data and other information pertinent to the audit.</li><li>
Participate in interviews of agency staff to elicit information.</li><li>
Help draft audit comments for audit reports.</li><li>
Prepare preliminary drafts of audit findings.</li><li>
Other duties as assigned by manager</li></ul><p><b>
Why work for the Auditor of State?</b></p><p>
The Auditor of State&rsquo;s office is the state&rsquo;s top financial watchdog. AOS Staff maintain the integrity of state fiscal operations while working in an unmatched flexible environment. Benefits include:</p><ul><li><p>
Hybrid work environment</p></li><li><p>
Four- or Five-Day Flexible Work Schedule</p></li><li><p>
Merit-Based Internal Promotion Structure</p></li><li><p>
CPA and Professional Certification Reimbursement Program</p></li><li><p>
Medical Benefits (Dental and Vision)</p></li><li><p>
Retirement Planning</p></li><li><p>
Work/Life Balance</p></li></ul><p></p><div>
These are just a few of the incredible benefits that the AOS has to offer you. We can offer you a meaningful career in public service!</div><b>
Why Work for the State of Ohio</b><p>
At the State of Ohio, we take care of the team that cares for Ohioans. We provide a variety of quality, competitive benefits to eligible full-time and part-time employees*. For a list of all the State of Ohio Benefits, visit our Total Rewards website! Our benefits package includes:</p>
<ul>
<li>Medical Coverage</li>
<li>Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period</li>
<li>Paid time off, including vacation, personal, sick leave and 11 paid holidays per year</li>
<li>Childbirth, Adoption, and Foster Care leave</li>
<li>Education and Development Opportunities (Employee Development Funds, Public Service Loan Forgiveness, and more)</li>
<li>Public Retirement Systems (such as OPERS, STRS, SERS, and HPRS) &amp; Optional Deferred Compensation (Ohio Deferred Compensation)</li>
</ul>
<ul><li>Benefits eligibility is dependent on a number of factors. The Agency Contact listed above will be able to provide specific benefits information for this position.</li></ul><b>
Qualifications</b><p><b>
Educational and Capability Requirements:</b>
</p><ul><li>Bachelor&rsquo;s Degree from accredited college or university (<b>Accounting preferred</b>)</li>
</ul>
<p>o OR successful completion of at least 16 semester hours or equivalent in accounting or related field from an accredited college, university, trade, technical or vocational school beyond high school level</p>
<p>
o OR possess at least three years&rsquo; experience in accounting or related field</p>
<ul>
<li>Knowledge of Microsoft office products preferred (Word, Excel, Outlook, PowerPoint)</li>
<li>Travel to Audit Site Work Locations</li>
</ul>
<p><b>Desired Characteristics</b></p>
<p>
You are detail-oriented, able to work under time-budget structure, organized, reliable, convey information professionally and work well with people at all job levels,<b> </b>communicate effectively, both orally and in writing. CPA and governmental accounting experience are a definitive plus.</p>
<p><b>
The AOS is an Equal Opportunity Employer. It is the policy of the AOS to prohibit discrimination and harassment of applicants and employees, due to race, color, religion, sex (including sexual harassment), sexual orientation, gender identity or expression, genetic information, national origin, ancestry, disability, age (40 years or older), veteran status or military status, status as a parent during pregnancy and immediately after the birth of a child, status as a nursing mother, status as a parent of a young child, or status as a foster parent. Discrimination, harassment, and/or retaliation will not be tolerated.</b></p>
<p></p><b>
ADA Statement</b><p>
Ohio is a Disability Inclusion State and strives to be a model employer of individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services, activities, programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws.</p></div></div>

Assistant Auditor 1

Trading & Construction Group

<p><b>Key Responsibilities:A. Accounting / Finance Duties</b></p><ul><li>Record daily sales, expenses, and operational costs</li><li>Assist in preparing monthly financial reports</li><li>Monitor petty cash and ensure proper liquidation</li><li>Handle invoice processing and supplier payments coordination</li><li>Support payroll computation and salary processing</li><li>Maintain accurate financial records and filing system</li><li>Coordinate with external accountant or auditor if required</li></ul><p><b>B. HR Duties</b></p><ul><li>Manage end-to-end recruitment process (job posting, screening, interview scheduling)</li><li>Prepare employment contracts, offer letters, and onboarding documents</li><li>Maintain employee records and HR filing system</li><li>Track attendance, leaves, and overtime</li><li>Assist in payroll preparation in coordination with finance records</li><li>Handle employee relations concerns and basic disciplinary documentation</li><li>Ensure compliance with labor laws and company policies</li><li>Coordinate visa processing, renewal, and related HR documentation (if applicable in KSA setup)</li></ul><p><b>C. Administrative Support</b></p><ul><li>Maintain proper filing system (HR and finance separation)</li><li>Coordinate with management for staffing needs</li><li>Assist in internal audits and compliance checks</li><li>Prepare HR and finance reports as required by management</li></ul><p><b>Must have valid Saudi driving license (or transferable equivalent) and own car.</b></p><p>Application Question(s):</p><ul><li>Do you have car and valid driving license?</li></ul><p>Location:</p><ul><li>Riyadh (Required)</li></ul><p>Work Location: In person</p>

Accounts and HR Officer

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