Compliance Auditor

Endeavor Health Services • Buffalo, NY

1d • Onsite

About The Position

The Compliance Auditor functions as staff to the Corporate Compliance Officer (CO) and serves as an in-house subject matter expert with respect to regulatory matters. The Compliance Auditor will provide internal stakeholders with directions on compliance audit issues and ensure adherence of compliance & regulatory standards. Responsible for ensuring compliance with governmental and internal requirements. Perform clinical audits and reviews throughout the agency which are designed to assess medical necessity, fidelity to best practices, quality of service delivery, and service outcome metrics, as necessary.

Requirements

• A bachelor’s degree is required.
• Must demonstrate expertise in the following areas of health care: data analytics, measurement, and analysis outpatient safety compliance with standards and regulations.
• Must have a working knowledge of 14 NYCRR Parts 587, 599, 822, 512 (PROS), OASAS Integrated Outpatient Regulations parts 825 and 598 Guidance, CCBHC regulations, ACT, and a general knowledge of behavioral health treatment.
• Sufficient knowledge and understanding of medical necessities.
• Must possess excellent verbal and written communication skills.
• Proficiency with MS office products and demonstrate strong computer skills
• Must be able to synthesize data, generate reports and make recommendations.
• Knowledge of CMS (Medicaid/Medicare), HIPAA and other federal and state health care regulatory compliance regulations.
• Must be highly organized, a quick learner, and detail oriented.

Nice To Haves

• In the field of Health Administration, Science or Nursing is preferred.
• Master’s degree is highly preferred.

Responsibilities

• Conduct probe, targeted, and retrospective audits to ensure regulatory and contractual compliance.
• Analyze compliance issues and partner with the Corporate Compliance Officer (CO) to implement corrective actions.
• Support external audits and regulatory site visits; ensure audit readiness and accurate documentation.
• Review medical records for completeness, accuracy, timeliness, and proper provider authentication.
• Ensure clinical documentation meets standards of care and federal/state regulations.
• Communicate audit findings, trends, and recommendations to leadership and staff.
• Collaborate with clinical teams to improve documentation supporting patient care and treatment plans.
• Serve as a resource on documentation and compliance requirements for staff and providers.
• Maintain compliance with agency policies and regulations, including HIPAA.
• Assist in training, risk assessments, and ongoing monitoring of compliance program effectiveness.
• Partner cross-functionally to support compliance initiatives and uphold ethical standards.

Benefits

• Medical, dental, and company-paid vision insurance
• Company-paid life insurance, AD&D, and long-term disability
• Optional short-term disability and additional life/AD&D coverage
• 401(k) with employer contribution
• Generous PTO, sick time, and 10 paid holidays
• Employee Assistance Program
• Discounted pet insurance
• Eligibility for student loan forgiveness through programs like Public Service Loan Forgiveness

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level