Robert Half Compliance Auditor--Healthcare in Dallas, Texas
Compliance Auditor needed for long-term audit engagement with our San Antonio healthcare client. Compliance Auditor will assist in the overall quality, compliance, and auditing activities to ensure compliance of standard operating procedures, corporate policies, industry standards, and applicable federal and state laws. Conducts audit activities and prepares reports summarizing audit results. Works in conjunction with Regional Director of Compliance and Privacy on compliance and privacy work plans, staff education, internal and external audits and reviews, and provides assurance that the organization is operating in an efficient and effective manner.
A. Performs compliance and privacy audit and monitoring activities and coordinates with the Regional team and the System Office as it relates to such audits.
B. Collaborates with Regional Director of Compliance and Privacy on external audits and reviews, which are initiated by government agencies or government-contracted organizations.
C. Coordinates medical record and claim reviews with the clinical and revenue cycle departments.
D. Performs monthly compliance and privacy audits according to the established work plan and calendar and prepares work plan summary slides with appropriate corrective action plans.
E. Modifies work plan calendar through the year to include additional audits, based on audit results, risks, and corrective action plans.
F. Serves as a member of the regional compliance committee and presents summary of compliance and privacy audit activities to the committee.
G. Provides subject matter expertise to the facility staff as directed by the Regional Director Compliance and Privacy.
POSITION SPECIFIC COMPETENCIES
A. Read, research, and understand the rules and regulations related to the audit, the scope of the audit, and the expected outcomes of the audit if all controls are in place and the audit goes as well as expected, prior to beginning the audit.
B. Complete work plan activities as directed by the Regional Compliance Director and Corporate Compliance Team and submit compliance and privacy work plan summary slides by the 5th working day of each month.
C. It is expected that Corrective Action Plans are implemented, tracked, and closed within 60 days.
D. Effectively communicate results of the work plan reviews to the Regional Compliance Director, the Corporate Compliance team, hospital departments, and the hospital compliance committee.
• Bachelor degree is preferred, though extensive experience in healthcare revenue cycle, nursing, auditing, clinical operations, privacy or compliance will be considered
· Knowledge of and experience with Meditech, One Content, and EPIC preferred
· Strong Skills with Microsoft products (Excel, Word, and Power Point)
· Five (5) years’ experience or more in nursing, healthcare revenue cycle, privacy, or compliance
· Knowledge with healthcare compliance and integrity policies required
· Strong knowledge of DRG, CPT, CDM and billing and clinical operations required
· Overall knowledge of hospital department operations
Licenses, Registrations, or Certifications
· HCCA CHC and CHPC certifications preferred
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