Lead Internal Auditor - Compliance (RN)

Community Health Network•Indianapolis, IN

9d•Remote

About The Position

Join Community Community Health Network was created by our neighbors, for our neighbors. Over 60 years later, “community” is still the heart of our organization. It means providing our neighbors with the best care possible, backed by state-of-the-art technology. It means getting involved in the communities we serve through volunteer opportunities and benefits initiatives. It means ensuring our dedicated caregivers can learn and grow to stay at the top of their fields and to better serve our patients. And above all, it means exceptional care, simply delivered — and we couldn’t do it without you. Make a Difference The Lead Internal Auditor (Compliance, RN) works under the general supervision of the Manager of Internal Audit, Physician Coding and Compliance and assists in reviewing various healthcare functions, with particular emphasis on compliance with coding, billing, and medical record documentation requirements for hospitals, physician practices, home health, long-term care, surgery centers, and more. Responsibilities include determining audit scope, developing audit plans, evaluating audit evidence, and drawing conclusions based on billing and federal/state regulations. This individual may also provide guidance or expertise to less experienced auditors on clinical/compliance issues and will draft audit reports to effectively communicate scope, work performed, results, and proposed action plans. Exceptional Skills and Qualifications Applicants for this position should be able to collaborate with others in a team setting, have excellent communication skills, and a positive attitude toward problem-solving. Bachelor of Science in Nursing (BSN) is required. In lieu of degree, a combination of education and experience will be considered. Minimum of five (5) years in healthcare auditing and/or internal control documentation and evaluation. Minimum of three (3) years as a Registered Nurse. Knowledge of coding/billing systems utilized in healthcare (CPT, HCPCS, ICD-10) and documentation/regulatory requirements for billing healthcare services. Certified Internal Auditor (CIA) or Certified Coding Specialist (CCS) certification preferred. This position will allow flexibility to work remotely. Community caregivers performing work remotely are permitted to live in the following states\: Indiana, Illinois, Ohio, Michigan, Kentucky, Florida and Texas. Caregivers are not allowed to perform work remotely outside of the above states. Applicants from other states may apply; however, if hired, they will be required to relocate to one of the above states within 60 days of their employment date. Prerequisite Skills Effective written and verbal communication skills. Strong planning, analytical, organizational, and business skills. Knowledge of healthcare systems, including coding and reimbursement expertise. Project management expertise. Perform audits to evaluate adequacy and effectiveness of internal controls. Recommend improvements to ensure compliance and financial integrity. Develop and refine audit programs; execute audit tests and interpret results. Draft clear, persuasive reports of findings and recommendations, present to leadership. Lead, direct, and supervise other auditors; serve as a resource for team members. Ability to work independently and collaboratively as part of a team.

Requirements

Applicants for this position should be able to collaborate with others in a team setting, have excellent communication skills, and a positive attitude toward problem-solving.
Bachelor of Science in Nursing (BSN) is required. In lieu of degree, a combination of education and experience will be considered.
Minimum of five (5) years in healthcare auditing and/or internal control documentation and evaluation.
Minimum of three (3) years as a Registered Nurse.
Knowledge of coding/billing systems utilized in healthcare (CPT, HCPCS, ICD-10) and documentation/regulatory requirements for billing healthcare services.
Effective written and verbal communication skills.
Strong planning, analytical, organizational, and business skills.
Knowledge of healthcare systems, including coding and reimbursement expertise.
Project management expertise.

Nice To Haves

Certified Internal Auditor (CIA) or Certified Coding Specialist (CCS) certification preferred.

Responsibilities

Determining audit scope
Developing audit plans
Evaluating audit evidence
Drawing conclusions based on billing and federal/state regulations
Draft audit reports to effectively communicate scope, work performed, results, and proposed action plans
Perform audits to evaluate adequacy and effectiveness of internal controls
Recommend improvements to ensure compliance and financial integrity
Develop and refine audit programs
Execute audit tests and interpret results
Draft clear, persuasive reports of findings and recommendations, present to leadership
Lead, direct, and supervise other auditors
Serve as a resource for team members
Ability to work independently and collaboratively as part of a team