Compliance Audit Manager

The Compliance Audit Manager will be responsible for contributing to the development of an auditing and monitoring program. Plan, assign, and complete compliance audits and reviews as per the annual compliance work plan and resulting from reports of non-compliance made through the Compliance and Ethics hotline and other sources.

Summary of Essential Job Functions

The key responsibilities of the Compliance Audit Manager include, but are not limited to:

• Design, perform and manage all aspects of compliance audits including plans to help assess risk and compliance across all areas of the organization and offer recommendations to mitigate company risk and exposure
• Identify and evaluate risk and assess systems of controls
• Lead and manage Compliance Auditors;
  Provide initial and on-going training for Compliance Auditors and other team members as applicable; and, review internal audits and provide feedback to Compliance Auditors
• Participate as a member of the organization's internal compliance committee
• Prepare and deliver executive summary memos and presentations to board, management, committees, or other stakeholders
• Identify, prepare, report, and manage audit findings and observations, including monitoring progress of action plans, while ensuring consistency of work papers, memos, internal audit reports, agendas and all other work products and assignments
• Manage the annual project plan through scheduling and meeting deadlines
• Demonstrate a high-level understanding of coding guidelines in the areas of Evaluation and Management, Mental Health, Substance Abuse, Lab, and others as applicable

• Maintain current knowledge of coding guidelines, laws, rules, policies, and regulations applicable to the organization's operations
• Coordinate and assist with the annual organizational risk assessment and work plan development and execution
• Monitor compliance with documentation guidelines and billing practices
• Serve as a subject matter expert for the development and implementation of policies related to coding and supports all team members to ensure compliance with organizational policies related to area of expertise and support all team members to ensure compliance with organizational policies and procedures related to area of expertise
• Ensure compliance with all federal and state regulatory bodies, as well as accrediting agencies and assist with preparation of responses to regulatory inquiries

• Assist with reviewing all reports related to billing and coding non-compliance and collaborate with appropriate compliance team members and other organizational stakeholders on subsequent investigations

Minimum Education al and Experience Requirements

• Bachelor's degree in healthcare field or equivalent experience
• Certified Professional Coder (CPC) or equivalent certification required
• Certified in Healthcare Compliance (CHC) or equivalent certification preferred
• Minimum five (5) years of previous healthcare compliance and auditing experience required
• Minimum one (1) year of previous supervisory or management experience required
• One (1) year experience in a mental health and/or substance use setting preferred
• Knowledge and experience related to CMS, OIG, and DOJ guidelines
• HIPAA Privacy Law and 42 CFR Part 2 Rules experience required
• Experience in working with regulatory and accrediting bodies
• Excellent verbal and written communication skills
• Excellent interpersonal skills
• Strong organizational skills with superior attention to detail
• Proficient with Microsoft Office Suite

Physical Requirements and Working Conditions

• Suitable home-office environment with internet
• Speaking and hearing ability sufficient to communicate effectively by phone or in person at normal volumes
• Vision adequate to read correspondence, computer screen, forms, etc.
• Ability to sit for long periods of time, some bending, stooping, and stretching
• Variable workload, periodic high stress, and activity level

Equal Opportunity Employer
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