Corporate Compliance Auditor - Inpatient Focus

Corporate Compliance Auditor - Inpatient Focus

LMHS Compliance Auditor

Licking Memorial Health Systems (LMHS) is a leading, non‑profit healthcare organization dedicated to improving the health and well‑being of our community. Founded in 1898, LMHS remains a cornerstone of healthcare excellence in Licking County, offering a comprehensive spectrum of patient care services – from life‑saving emergency medicine to home healthcare – and specialized services in cancer, heart health, maternity, and mental wellness.

When you join the LMHS team you become a vital part of your local community hospital. Working at LMHS is not just a job, it is an opportunity to directly impact the health and well‑being of friends, family, and neighbors. Your work extends beyond hospital doors into the heart of our community. Our commitment to diversity, equity, and inclusion ensures that every member of our community is served with respect and compassion.

Under the general direction of the VP of Financial Services, this position provides overall compliance auditing and monitoring of the Health Systems. This position safeguards the Health Systems compliance with state and federal documentation and billing requirements.

• Primary focus on the compliance of home care, patient level of care, and patient status, and responsible for internal auditing of processes and practices to assure consistency with federal and state law, including compliance with CMS, OIG, ODH, ODM, and RAC.
• Communicate with external agencies regarding audits.
• Audit charge capture processes, coding and billing processes, and assist in resolution of case or system failures.
• Provide consultation in the application of process improvement principles related to the results of any compliance audit functions and findings.
• Guide and advise staff on Medicare and Medicaid regulations and billing practices.
• Offer expertise to departmental personnel and medical staff in coding, billing, and compliance.
• Effectively work with multi-disciplinary groups, coordinating with physicians, nurses, and other healthcare professionals.
• Research regulations, rules, and laws to analyze concerns, develop well‑reasoned solutions, recognize and validate assumptions, collect information, and draw meaningful inferences.
• Maintain confidentiality and a sense of credibility and reliability.

• Licensed Practical Nurse (LPN), Registered Nurse (RN), or bachelor’s prepared individual with significant healthcare and auditing experience. Clinical background is strongly preferred.
• Minimum of three to five years in a healthcare setting.
• Knowledge of Medicare/Medicaid laws.
• Superior interpersonal, analytical and computer skills, with the ability to work independently.
• Background and knowledge necessary to assess clinical documentation and medical record coding, analyze data and identify trends and outliers.
• Excellent written and verbal communication skills to support professional communication with all management levels.
• Healthcare auditing experience preferred.
• Not a remote position.
• LMH is accredited by DNV and TJC, and may require specific annual education related to specialty certifications and standards.

Licking Memorial Health Systems is an equal opportunity employer and maintains compliance with all state, federal, and local regulations. Licking Memorial Health Systems does not discriminate against applicants because of race, religion, color, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, family medical history or genetic information, political affiliation, military service, or other non‑merit based factors protected by law.