Compliance Auditor Day Shift

Compliance Auditor (FT- 1.0, Day Shift) page is loaded## Compliance Auditor (FT- 1.0, Day Shift) locations:
Bozeman, MTtime type:
Full time posted on:
Posted 30+ Days Agojob requisition :
R12661
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* Position Summary:

** The Compliance Auditor supports an effective compliance program by planning and executing risk-based audits, monitoring adherence to federal and state regulations, and evaluating internal controls and procedures. The role partners with departments across the organization to assess billing, coding, privacy/security, and operational practices; identifies vulnerabilities; and recommends corrective actions that promote ethical, compliant operations. The position prepares clear reports for leadership and supports survey readiness, investigations, and ongoing education to sustain compliance.
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* Qualifications:

*** Bachelor’s degree in healthcare administration, business, accounting, or related field.
* Professional certification (e.g., Certified in Healthcare Compliance (CHC), Certified Professional Compliance Officer (CPCO)); or ability to obtain within twelve (12) months of hire.
* Three (3) years of experience in healthcare compliance, auditing, or a related field.
* * Intermediate knowledge and experience reviewing clinical documentation, billing, and coding for compliance.*
* * Intermediate knowledge and experience with electronic health records (EHR) systems (preferably Epic) and compliance/audit management tools.*
* * Intermediate knowledge of CMS guidelines, payer requirements, HIPAA Privacy and Security Rules, and foundational healthcare regulations (e.g., Anti**‑
** Kickback Statute, False Claims Act, EMTALA).*
* * Intermediate proficiency with Microsoft Excel and report preparation; familiarity with statistical sampling methods for audits.
*** Preferred:
*** Master’s degree in healthcare administration, business, accounting, or related field.
* Certified Professional Coder (CPC) or similar coding credential.
* * Prior experience supporting regulatory surveys/investigations and accreditation standards (e.g., Joint Commission, CMS Conditions of Participation).*
* * Experience in small to mid-size healthcare organizations and with quality improvement methodologies.
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* Essential Job Functions:

** In addition to the essential functions of the job listed below, employees must have on-time completion of all required education as assigned per DNV requirements, Bozeman Health policy, and other registry requirements.
* Develops and maintains a risk‑based annual audit plan aligned with organizational risks and OIG work plan priorities.
* Conducts audits of clinical documentation, billing, coding, and operational processes to evaluate compliance with applicable laws, regulations, payer rules, and internal policies.
* Reviews medical and billing records for coding accuracy and medical necessity; validates documentation sufficiency and identifies trends.
* Monitors adherence to HIPAA privacy and security requirements, including appropriate handling of PHI and breach prevention practices.
* Investigates reported compliance concerns and hotline allegations; documents findings, determines root causes, and recommends corrective actions.
* Prepares clear, concise audit reports and dashboards; presents results and risk‑based recommendations to leadership and stakeholders.
* Tracks and validates completion of corrective action plans (CAPs) to ensure timely and sustained remediation.
* Supports preparation for and response to regulatory surveys, inquiries, and external audits; coordinates evidence collection and responses.
* Maintains compliance data repositories, audit work papers, and tracking systems with accurate, timely documentation.
* Collaborates with departmental leaders to prioritize work, coordinate information requests, and minimize operational disruption during reviews.
* Assists in developing and delivering compliance education for leaders, providers, and staff; supports onboarding and orientation activities.
* Stays current on changes in healthcare regulations and payer policies; communicates impacts and updates procedures accordingly.
** Knowledge,

Skills and Abilities

*** Demonstrates sound judgment, patience,…