Senior, Compliance Auditor

Overview

Emory Healthcare is committed to professional growth and offers best‑in‑class benefits, mentorship, and leadership opportunities that empower individuals to reach new heights in their careers.

• Comprehensive health benefits starting day 1
• Student Loan Repayment Assistance & Reimbursement Programs
• Family‑focused benefits
• Wellness incentives
• Ongoing mentorship, development, and leadership programs
• And more

Atlanta, GA

• The Senior 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 HHS‑OIG, CMS, and other regulatory agencies.
• The position serves as a strategic advisor to executive leadership, clinical leaders, and the Compliance Committee.
• Strategic & Leadership
  • 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
• Healthcare Compliance Auditing
  • 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 over payment exposure
  • Ensure audit work papers meet legal defensibility and regulatory standards
• Regulatory & Enforcement Support
  • Support internal investigations related to potential fraud, waste, abuse, or regulatory noncompliance
  • Assist with government audits, payer audits, RAC audits, and regulatory examinations
  • Support over payment 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
• Travel:
  Travel to Emory Affiliated locations as required
• Work Type:
  Hybrid employee – splits time between working remotely and working in the office

• Education:
  
  Bachelor’s degree in Healthcare Administration, Nursing, Health Information Management, Accounting, Finance, or related field
• Experience:
  
  7+ years 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

• Education:
  
  Master’s degree (MHA, MBA, MSN, JD, or related)
• Experience:
  
  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
• Certification:
  Professional certifications strongly preferred
  • CHC, CHPC, CHC‑F
  • CIA, CPA, CFEi>
  • RHIA, RHIT, CCS, CPC

Reports to the Chief Compliance Officer or VP, Compliance & Integrity

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