Per Diem - Corporate Compliance Auditor

Chapters Health • Temple Terrace, FL

2d

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, reviews and analyzes compliance data, researches problems, evaluates compliance with organizational controls and benchmarks, and recommends improvements. It also supports medical reviews of clinical documentation, reimbursement compliance, affiliate denials, and medical record information requests.

Requirements

• Bachelor’s degree in a relevant field or an equivalent combination of education and experience.
• At least two years of related experience.
• Strong skills using Microsoft Office, including Excel and PowerPoint.
• Skill in pain and symptom control management.
• Detail-oriented and knowledgeable in clinical standards of practice.
• Experience with chart audit review and 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

• Perform patient record audits to ensure staff and Company policies comply with regulatory requirements while maintaining 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 audit findings and provide recommendations to the Director of Compliance/Risk weekly.
• Provide written and verbal reports to Clinical Administration at each affiliate regarding patient eligibility, documentation, and other concerns about patient records of care.
• 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, with the Director of Compliance/Risk, affiliate denials and processes for medical record information requests.
• Perform other duties as assigned.
• Represent the Company professionally and provide care and services to clients.
• Comply with applicable government regulations, Company policies and procedures, and health, safety, and security practices; maintain a strong position against fraud and abuse.
• Maintain confidentiality and use resources in a fiscally responsible manner.
• Participate in community and professional organizations and support organizational, departmental, and individual performance improvement.
• Improve professional knowledge and skills, advance electronic media skills, support Company research and educational activities, and share expertise with coworkers.

What This Job Offers

• Career Level: Mid Level