Compliance Audit Manager - Clinical Research

McKesson • Irving, TX

12h • Hybrid

About The Position

McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve – we care. What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow’s health today, we want to hear from you. Title: Compliance Audit Manager – Clinical Research Hub locations: Atlanta, GA; Columbus, OH; Dallas, TX; (Preferred) Remote/Onsite/Hybrid: Hybrid position The Research Compliance and Ethics team is responsible for conducting audits to confirm that McKesson’s research programs and billing activities are conducted in an ethical manner and in accordance with applicable laws, rules, and regulations. The Compliance Audit Manager – Clinical Research will be responsible for conducting routine audits of research billing at McKesson’s network of oncology practices that conduct clinical research. The ideal candidate will also assist the Director, Research Compliance & Ethics with managing and enhancing the Research Billing Compliance program.

Requirements

• Degree or equivalent
• 4+ years of relevant experience
• The ideal candidate will have 4+ years of auditing experience and relevant experience in clinical research.
• Demonstrated knowledge of Medical Terminology and Anatomy & Physiology combined with expertise in federal payor guidelines/third-party payer reimbursement, coding, and documentation requirements.
• Ability to understand and follow department standard operating procedures relating to billing and coding audits.
• Proficient in Microsoft 365 applications.
• Ability to work independently and proactively.
• Extremely detail-oriented with superior organizational and analytical skills.
• Ability to use data and analytics to advance compliance audit program efficiency and effectiveness.
• Ability to conceptualize results of billing and coding audits to identify patterns, trends, and variations in coding, documentation practices, operational workflows, and billing practices.
• Minimum Education & Typical Experience or Equivalent Combination: Degree or equivalent and typically requires 4+ years of relevant experience.
• Must be authorized to work in the US.
• Sponsorship is not available for this position.

Responsibilities

• Abstract and perform research billing audits of charge data using medical records to validate that charges were billed in accordance with company billing guides and Medicare requirements (as applicable).
• Document results and corrections in a clear manner, accurately and concisely providing supporting evidence from the medical record and/or other references.
• Assist in developing an annual risk-based audit plan, and complete audits within the defined audit schedule timeline.
• Prepare audit reports of findings and recommendations for improvement for internal review and communicate results to business, research site and Compliance leadership.
• Collaborate with the Research Operations group to ensure audit findings are accurate and translate into actionable education for the network, where appropriate.
• Maintain an up-to-date working knowledge of Medicare requirements for billing routine charges for research participants.
• Ensure strict confidentiality of patient information.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees