Summary of Essential Functions for the Position:
Under the direction of the VP of Compliance, the Senior Compliance Auditor assists in planning, developing and directing of audits in accordance with the Agency’s Corporate Compliance Policy, accreditations and policies and procedures. Conducts and reviews organizational activities and evaluates the adequacy and effectiveness of management controls. Travels to assigned field locations to ensure compliance with Federal and State regulations, Agency’s accreditations and policies and procedures. Maintains consistent communication with the Agency’s leadership team, including Director of Clinical Services/Clinical Manager and field staff. Has access to confidential and restricted files; high level of confidentiality and discretion of information audited, required at all times. Collaborates with VP of Compliance to identify priorities, determine clinical, operational, and training needs and recommends actions to drive improvement. Provides oversight of audits and assigns to compliance staff on a consistent basis.
Qualifications / Licensure / Certification / Knowledge / Skills / Abilities:
• Currently licensed in the state(s) in which practicing.
• HCCA or equivocal Healthcare Compliance Certification preferred.
• Ability to work within a team environment and with short deadlines.
• Must be well organized and demonstrate attention to detail, with the ability to think analytically.
• Strong communication skills, both oral and in writing, with excellent interpersonal skills.
• Must demonstrate good customer relations skills and a commitment to providing quality service.
• Ability to research and apply related knowledge specific to Federal, State, local laws, accreditation and Medicare Coverage Criteria to ensure branch compliance with daily operations and billing practices.
• Proficient with a computer and Microsoft Word, Excel and Outlook software. Working knowledge of EMR database.
• Must have a valid driver’s license, auto liability insurance and reliable transportation.
• Up to 100% travel may be required.
High School Diploma or GED. Bachelor’s Degree preferred in applicable field business, accounting, finance, information systems, or healthcare related (CPA, CIA, RN, PT). Certified in Healthcare Compliance (CHC) preferred.
Working Conditions & Physical Requirements:
Works indoors in Agency office and patient homes and travels to/from patient homes. Requires considerable physical effort most of the day including kneeling, squatting, reaching, twisting, climbing, walking, exposure to temperature and humidity changes and maximal assist in lifting and/or transferring of a 100-pound patient. Must possess sight/hearing senses or use appropriate adaptive devices that will enable senses to function at a level required to meet the essential duties of the position. Must provide evidence of annual TB test and other state-
required tests or examinations. Be able to tolerate exposure to elements including, but not limited to, odors,
blood, body fluids and excrements, adverse environmental conditions and hazardous materials.