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NOA Letter Clinical Auditor

https://www.cvshealth.com/ Logo

CVS Health

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Location:
United States

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Category:
-

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Contract Type:
Not provided

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Salary:

22.40 - 53.53 USD / Hour

Job Description:

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate 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. The NOA (Notice of Action) Letter Clinical Auditor is responsible for auditing NOA letters for both Medicare and Medicaid markets, in order to ensure compliance with regulatory guidelines, clinical accuracy, and clarity. 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.

Job Responsibility:

  • Audit NOA letters for compliance with AHCCCS (Arizona Health Care Cost Containment System), CMS (Centers for Medicare & Medicaid 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
  • Provide 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 current with changes in clinical guidelines and regulatory requirements
  • Assist in completing NOA letters and faxes when needed due to volume
  • Help translate complex medical language into member-friendly terms

Requirements:

  • Active or unrestricted LPN licensure in the state of residence
  • Must reside in Arizona, California, Washington, Oregon, or Nevada
  • 2+ years of experience in healthcare
  • Minimum 1 year of experience navigating internal/external computer systems, including an ability to interpret clinical documentation and apply policy guidelines
  • Demonstrated proficiency in Microsoft Suite, including spell and grammar check
  • Associate’s degree in Practical Nursing and/or LPN vocational certification/diploma

Nice to have:

  • 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 Medicaid/Medicare environment
  • Familiarity with QNXT or similar systems
  • Ability to explain complex medical concepts in plain language
What we offer:
  • Affordable medical plan options
  • 401(k) plan (including matching company contributions)
  • Employee stock purchase plan
  • No-cost wellness screenings
  • No-cost tobacco cessation and weight management programs
  • No-cost confidential counseling
  • No-cost financial coaching
  • Paid time off
  • Flexible work schedules
  • Family leave
  • Dependent care resources
  • Colleague assistance programs
  • Tuition assistance
  • Retiree medical access

Additional Information:

Job Posted:
March 04, 2026

Expiration:
March 06, 2026

Employment Type:
Fulltime
Work Type:
Remote work
Job Link Share:

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