Compliance Auditor

Centria Autism•Farmington Hills, MI

5h•$55,000 - $70,000•Hybrid

About The Position

Under the direction of the Director of Compliance Audit, the Compliance Auditor is responsible for designing, planning, and executing internal compliance audits to satisfy the requirements of the Compliance Program at Centria. Additionally, the Compliance Auditor will facilitate Centria’s response to payor audits and other audits required by external parties. The Compliance Auditor will provide ongoing monitoring of audit results and, if required, coordinate the development and implementation of a plan of correction.

Requirements

Associate degree
Basic computer skills
Working knowledge of laptop/desktop PC
Proficiency in Microsoft Suite
Proficiency in G Suite
Ability to follow written instructions
Ability to use computers and computer/software programs
Ability to communicate expressively and receptively
Excellent communication skills, both written and verbal.
Data-driven with an aptitude for interpreting results and firm adherence to process.
Comprehensive understanding of payor requirements and proficiency in navigating CareConnect.
Track record of success in payor audit responses.
Knowledge of ABA requirements for nationwide payors.
Strong understanding of Centria operational processes with the ability to work collaboratively with other departments in collecting documentation.
Knowledge of computer systems related to compliance, operational, and HR functions.
Knowledge of audit and compliance process.
Ability to organize, prioritize and handle multiple tasks, adhere to established deadlines, and produce work that consistently meets or exceeds team benchmarks.
Proven adaptability with a willingness to work both collaboratively and individually to achieve desired business outcomes.
Excellent interpersonal and listening skills.
Demonstrated strong work ethic with attention to detail, accuracy, and quality.
Established track record of generating error-free work.

Nice To Haves

Bachelor’s degree
Knowledge of healthcare compliance program elements
Knowledge of medical terminology and clinical concepts

Responsibilities

Develop and execute an annual Audit Plan that complies with Compliance Program guidance from OIG/DOJ and federal/state regulatory requirements.
Independently document internal and external audit plans, analyze findings to prepare comprehensive reports, and oversee the implementation of corrective actions. Manage the integrity and retention of all audit materials.
Store and catalog all audit materials for future review if required.
Perform additional compliance audits as requested by operational leadership and approved by the Senior Director of Quality Compliance to ensure adherence to all internal policies and procedures and federal/state regulatory requirements.
Conduct site visits to perform spot audits as needed or directed (up to 10% travel).
Coordinate responses to payor audits and other audits by external parties.
Work across multiple internal systems to ensure audit submissions are comprehensive, accurate, and clearly understood.
Handle requests, physical arrangements, obtaining documents, and compiling information for external audits by payors.
Remain up to date on all payor and company audit requirements, and remain trained on payor portals, internal systems, dashboards, and all other necessary information systems to ensure the full breadth of a process can be examined.
Provide weekly, monthly, and quarterly feedback regarding audit activity to the Chief Compliance Officer.
Coordinate the development, submission, and monitoring of required Corrective Action Plans (CAPs).
Meet with internal stakeholders to review CAPs, set expectations, and meet submission deadlines.
Maintain and evaluate the CAP tracker to ensure organizational accountability and timely resolution of risks.
Conduct an internal audit, post submission, to ensure payor concerns are being addressed as promised.
Compliance with Centria’s Code of Conduct, policies and procedures, and Federal and State laws.
Responsibility to report violations of Company policies or the Code of Conduct.