Corporate Director, Compliance Auditor

Emory Healthcare•Tucker, GA

8d•Hybrid

About The Position

The Corporate Director Compliance Auditor - Healthcare Provider provides expert leadership in evaluating and strengthening the organization's compliance program across clinical, billing, privacy, and operational domains. This role leads complex, risk-based compliance audits to ensure adherence to federal and state healthcare regulations and guidance from Healthcare Compliance Association, HHS-OIG, CMS, and other regulatory agencies. The position serves as a strategic advisor to executive leadership, clinical leaders, and the Compliance Committee.

Requirements

Bachelor's degree in Healthcare Administration, Nursing, Health Information Management, Accounting, Finance, or related field
7years of progressive experience in healthcare compliance auditing, internal audit, or regulatory compliance
Medicare and Medicaid billing rules
Clinical documentation and coding standards
HIPAA Privacy and Security Rules
Physician compensation and contracting requirements
Proven experience conducting risk-based compliance audits in a provider environment
Excellent ability to communicate complex compliance issues to clinical leaders and executives
Deep healthcare regulatory expertise
Clinical and operational acumen
Executive presence and judgment
Independence and objectivity
Advanced analytical and investigative skills
Ability to influence clinicians and administrators

Nice To Haves

Master's degree (MHA, MBA, MSN, JD, or related)
in hospital systems, academic medical centers, or multi-site provider organizations. Familiarity with EHR systems, revenue cycle workflows, and clinical operations
Experience supporting OIG audits, DOJ inquiries, CMS surveys, or payer investigations
Professional certifications strongly preferred: CHC, CHPC, CHC-F, CIA, CPA, CFE, RHIA, RHIT, CCS, CPC

Responsibilities

Lead the development and execution of the annual healthcare compliance audit and monitoring plan based on enterprise risk assessments
Advise the Chief Compliance Officer, Compliance Committee, and executive leadership on regulatory risk exposure, audit findings, and remediation priorities
Provide mentorship and technical oversight to compliance auditors, analysts, or coders, as applicable
Prepare and present executive and Board-level audit reports and trend analyses
Lead and perform audits to assess the design and effectiveness of internal controls, policies, and compliance safeguards in high-risk areas identified in the risk assessment
Identify root causes, systemic risks, and potential overpayment exposure
Ensure audit workpapers meet legal defensibility and regulatory standards
Support internal investigations related to potential fraud, waste, abuse, or regulatory noncompliance
Assist with government audits, payer audits, RAC audits, and regulatory examinations.
Support overpayment identification, quantification, and repayment in coordination with Legal and Finance Corrective Action & Continuous Improvement
Oversee development and implementation of corrective action plans (CAPs)
Validate remediation through follow-up audits and ongoing monitoring
Enhance continuous monitoring tools, dashboards, and audit methodologies
Partner with operational leaders to improve documentation, controls, and compliance culture
Additional Duties as Assigned