Compliance & Audit Partner

** Overview*
* ** Be inspired**  **.*
* ** Be rewarded. Belong. At Emory Healthcare.*
* At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoingmentorshipand leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide:

+ Comprehensive health benefits that start day 1

+ Student Loan Repayment Assistance & Reimbursement Programs

+ Family-focused benefits

+ Wellness incentives

+ Ongoing mentorship, _development,_ and leadership programs

+ And more

** Description*
* ** OVERVIEW:*
* + Emory Healthcare, Office of Compliance & Privacy (OCP) seeks a Compliance & Audit Partner to support systemwide compliance and education initiatives, reporting, trends analysis, as well as policy and procedure management.

+ This individual would be responsible for ensuring that a healthcare organization adheres to relevant laws, regulations, and industry standards, focusing on compliance risk areas and billing practices, while also providing ongoing educational support, and fostering a culture of compliance within the provider network.

*
* KEY RESPONSIBILITIES:

*
* ** 1. MANAGEMENT & COMMUNICATION:*
* + Support the OCP by addressing all relevant laws, regulations, and industry standards.

+ This includes staying informed about changes in healthcare regulations and industry standards and update training accordingly.

+ Formulate, review, and revise compliance policies and SOPs, as directed. Participate in enterprise compliance risk assessment.

+ Investigate compliance matters reported via the Emory Trust Line and the EHC Compliance office.

+ Work to ensure timely resolution of Compliance issues and facilitates communication of compliance related matters.

+ Development governance-level reporting and metrics for the EHC Compliance Office, including but not limited to dashboards, board reporting, weekly, monthly, and annual compliance & ethics reporting.

+ Work with Senior Compliance and Privacy Office leadership as well as other key clinical and operational leaders on compliance matters.

+ Ensure that policies and procedures are effectively communicated and enforced throughout the organization.

** 2. EDUCATION & TRAINING PROGRAM:*
* + Develop and delivery of compliance training programs for providers and other stakeholders to ensure accurate and compliant coding, with an emphasis on Evaluation and Management (E/M) services, procedural coding, and clinical documentation improvement.

+ Participate in provider orientation to ensure coding and documentation expectations are clearly communicated.

+ Collaborates with compliance auditors and revenue cycle teams to identify trends, address deficiencies to ensure compliance within the organization.

+ Monitor regulatory changes from CMS, AMA, and other authorities; update educational materials accordingly.

+ Track and report on education effectiveness and compliance risks.

** 3. AUDITING & REPORTING:*
* + Participate in specialty and high-risk internal audits and reviews to assess compliance with policies and procedures.

+ Participate in compliance risk assessments, monitoring, tracking and trending.

+ Investigate potential compliance violations and report findings to appropriate authorities.

+ Collaborate with other departments and stakeholders to promote compliance throughout the organization.

+ Serve as an additional point of contact for compliance-related questions and concerns.

+ Ensure that policies and procedures are effectively communicated and enforced throughout the organization.

*
* MINIMUM QUALIFICATIONS:

*
* + Bachelor's degree required. Masters (MA or MS) or Juris Doctorate (JD) degree preferred.

+ Minimum of five years of experience in a healthcare organization.

+ Healthcare compliance role is preferred.

+ A minimum of five years of experience working as a medical coder, coding auditor, and/or coding educator.

+ Certified in Healthcare Compliance (CHC or CPCO) preferred. If no certification, must obtain one within 12 months of hire.

- AHIMA or AAPC certification required (e.g., CPC, CCS-P, CCS, CPMA, COC)

+ Strong knowledge of teaching physician rules, E/M leveling, and/or split/shared services.

+ Experience working in multispecialty practices, hospital-based clinics, or academic medical centers preferred.

+ Strong knowledge of HIPAA, Stark-Law, and other healthcare privacy regulations.

** KNOWLEDGE, SKILLS, AND ABILITIES REQUIREMENTS:*
* + Ability to work on a team and work independently, when needed.

+ Ability to adjust to changing work demands and multi-task.

+ Thorough attention to detail and strong, problem-solving skills.

+ Strong understanding of healthcare regulations, laws, and industry standards.

+ Strong understanding of CMS and correct coding and billing requirements

+ Excellent communication, interpersonal, and problem-solving skills.

** Work Environment:
Hybrid: 2-3 days/week onsite - Some local travel may be required for audits, training, or regulatory meetings.*
* **…