Head of Audit and Compliance (Vice President)

Aeroflow Health•Asheville, NC

About The Position

The Head of Audit and Compliance leads Aeroflow Health’s healthcare compliance and audit programs across its business units and applicable subsidiaries. The role develops practical controls to support compliant operations, accurate billing, and readiness for payer and regulatory review. Reporting directly to the General Counsel, the leader oversees internal compliance audits, external payer audit responses, compliance investigations, and corrective action, and provides candid reporting on material risks and program effectiveness. The position establishes and maintains a risk-based compliance program, including policies, training, reporting channels, investigations, monitoring, and accountability. It leads enterprise compliance risk assessment and audit planning; advises business leaders on requirements affecting DME, telehealth, patient education, and other healthcare services; and coordinates oversight of billing integrity, documentation, medical necessity, provider requirements, credentialing and enrollment, exclusions screening, and fraud, waste, and abuse controls. The role directs internal reviews of claims and related records and controls across Medicare, Medicaid, and commercial payer programs. It leads external audit responses and corrective action, works with Legal and operational partners on appeals and audit strategy, and ensures findings receive practical remediation and follow-up testing. It also oversees investigations, escalation of significant risks, audit and investigation records, personnel and resources, and reporting to leadership and, when authorized or required, the board or an appropriate committee. The position partners with the Privacy Officer and supports compliance integration for acquisitions and new services.

Requirements

Bachelor’s degree in healthcare administration, business, accounting, nursing, or a related field, or an equivalent combination of relevant education and experience.
At least eight years of progressive healthcare compliance, audit, reimbursement, or regulatory experience.
At least three years leading a team or a significant enterprise program.
Substantial experience with Medicare, Medicaid, and commercial payer requirements, healthcare billing and documentation audits, external payer reviews, and corrective action.
Working knowledge of healthcare fraud and abuse requirements, including the False Claims Act, Anti-Kickback Statute, and applicable state requirements, and ability to identify issues requiring legal advice.
Demonstrated ability to conduct sensitive investigations, analyze claims and operational data, communicate findings clearly, and influence leaders across business functions.

Nice To Haves

Juris Doctor strongly preferred.
Experience with DME suppliers, multistate healthcare operations, telehealth, or patient education programs.
Certified in Healthcare Compliance (CHC).
Experience improving audit workflows, implementing compliance dashboards, and supporting acquisitions or rapidly growing healthcare organizations.

Responsibilities

Establish and maintain a risk-based compliance program encompassing policies, training, reporting channels, investigations, monitoring, and accountability.
Lead an annual enterprise healthcare compliance risk assessment and maintain an audit and compliance work plan addressing emerging risks and business priorities.
Advise business leaders on compliance requirements affecting DME, telehealth, patient education, and other healthcare services, in partnership with Legal and clinical leadership.
Coordinate oversight of billing integrity, documentation, medical necessity, ordering and referring provider requirements, credentialing and enrollment, exclusions screening, and fraud, waste, and abuse controls.
Maintain HIPAA and patient confidentiality and comply with applicable laws, regulations, and policies.
Direct internal reviews of claims, patient records, orders, authorizations, proof of delivery, and related operational controls across Medicare, Medicaid, and commercial payer programs.
Lead responses to prepayment and postpayment audits, documentation requests, and corrective action requirements; track deadlines, findings, denials, and outcomes centrally.
Partner with Legal, Revenue Cycle, clinical teams, and outside advisors on appeals, disputed findings, repayment analyses, and audit strategy.
Ensure audit findings identify root causes and practical remediation, with accountable owners, completion dates, and follow-up testing.
Oversee compliance reporting and investigate suspected misconduct, billing concerns, and policy violations, coordinating with Legal, HR, and the Privacy Officer as appropriate.
Promptly escalate potential overpayments, systemic billing issues, fraud concerns, and significant control failures to the General Counsel; support investigation and resolution within applicable deadlines.
Maintain complete and objective audit and investigation records and follow Legal’s direction on matters conducted under counsel.
Lead, coach, and develop audit and compliance personnel; manage priorities, resources, and external support within the approved budget.
Present risk reports and dashboards to the General Counsel and leadership, and to the board or an appropriate committee as authorized or required by the Company’s governance structure.
Partner with the Privacy Officer on shared risks while retaining responsibility for healthcare compliance and payer audit oversight; support compliance integration for acquisitions and new services.

Benefits

Competitive pay
Health plans with FSA or HSA options
Dental insurance
Vision insurance
Optional life insurance
401(k) with company match
12 weeks of parental leave for birthing parents and 4 weeks for non-birthing parents
Fertility stipends
Free diapers
Breast pump
Paid holidays
PTO accrual from day one
Employee Assistance Programs