Per Diem - Corporate Compliance Auditor
Chapters Health System•Temple Terrace, FL
About The Position
The Corporate Compliance Auditor assists the Director of Compliance/Risk in planning, developing, and coordinating affiliates’ quality improvement programs and related performance improvement projects involving regulatory compliance for admissions and recertification. The role audits patient records, analyzes audit and regulatory outcome data, assesses compliance with organizational controls and benchmarks, and reports findings and recommendations to compliance and clinical leaders. It also coordinates medical reviews of clinical documentation, supports compliance with reimbursement guidelines, and helps identify and address opportunities for improvement.
Requirements
- Bachelor’s degree in a relevant field or an equivalent combination of education and experience.
- Minimum of two years of related experience.
- Strong skills using Microsoft Office, including Excel and PowerPoint.
- Skill in pain and symptom control management.
- Detailed-oriented and knowledgeable in clinical standards of practice.
- Experience with chart audit review.
- Experience compiling data.
- Strong documentation skills.
- Excellent verbal and written communication skills.
- Satisfactorily complete competency requirements for the position.
Nice To Haves
- Licensed Registered Nurse (RN).
- Compliance and audit experience.
- Hospice experience.
Responsibilities
- Audit patient records to ensure staff and Company policies comply with regulatory requirements while maintaining the confidentiality of Company records.
- Collect, review, and analyze data related to audit functions, including regulatory outcome measures, for the Director of Compliance/Risk to report to the Audit and Compliance Committee.
- Research problems and errors to determine their origin and appropriate resolution.
- Evaluate compliance with the Organization’s control and benchmark requirements.
- Summarize findings and provide recommendations to the Director of Compliance/Risk weekly.
- Provide written and verbal reports to Clinical Administration at each affiliate concerning patient eligibility, documentation, and other patient-record-of-care concerns.
- Coordinate medical reviews of clinical documentation to ensure compliance with reimbursement guidelines and educate staff on medical reviews.
- Evaluate trends, identify improvement opportunities, and present them to the Director of Compliance/Risk for timely prioritization.
- Coordinate affiliate denials and medical-record information requests in conjunction with the Director of Compliance/Risk.
- Perform other duties as assigned.
- Represent the Company professionally and provide care or services to clients.
- Comply with applicable government regulations, Company policies and practices, and health, safety, and security requirements.
- Maintain confidentiality, use resources responsibly, and participate in improving organizational, departmental, and individual performance.
- Improve professional knowledge and skills, advance electronic media skills, support Company research and educational activities, and share expertise with coworkers.
- Promote the Company through participation in community and professional organizations.
