Compliance Auditor/Educator
Core
Ensure compliance with federal healthcare program rules and regulations by developing policies, conducting audits, and educating staff on regulatory requirements.
Role type
Senior Compliance Auditor and Educator
Builds
Compliance work plans, audit reports, and educational training programs
Domain
Healthcare / Regulatory Compliance
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Knowledge of hospital revenue cycle processes, knowledge of hospital regulatory and payor guidelines, data analytical reporting, regulatory research, medical record billing review, corrective action planning, educational presentation delivery
Preferred skills
HCCA Certified in Healthcare Compliance (CHC), excellent presentation skills, ability to utilize electronic medical record and billing systems
Technologies
Electronic medical record systems, billing systems
Responsibilities
Participate in annual assessment of regulatory risk and develop compliance work plans; formulate scope and objectives of audits; evaluate audit scope and compile data analytical reports to identify audit universe; communicate with staff to conduct audits and bring corrective actions to closure; conduct compliance audits to prevent fraud, waste, and abuse; support revenue integrity controls through analysis of charge capture and coding; perform regulatory and policy research; review medical record billing and documentation; author audit summaries for Board committees; lead meetings to review audit reports and develop corrective action plans; conduct and facilitate educational activities and presentations for the Compliance Department
Seniority
Senior, hands-on IC
