Clinical Compliance Auditor
Company: Encompass Health
Posted on: June 24, 2022
POSITION PURPOSE The Clinical Compliance Auditor executes audits
as a part of the company's compliance audit and controls program.
The Clinical Compliance Auditor executes clinically-related (i.e.
medical record and related billing) audit procedures to assess
compliance-related controls to safeguard company resources, and
ensures the effectiveness and efficiency of operations. This
position, in conjunction with other Compliance team members, makes
recommendations for improvement of controls and processes to ensure
risk management, control, and governance systems are functioning as
intended and will enable company's objectives and goals to be met.
RESPONSIBILITIES AND TASKS
- Assists Compliance Audit Manager and Senior Compliance Auditor
in planning activities.
- Participates in preparing audit programs based upon the defined
- Executes/records audit procedures in accordance with Compliance
Audit work paper standards.
- Identifies and prioritizes potential exceptions, exposures and
opportunities for management review.
- Works with client management and staff to obtain concurrence on
issues and recommendations.
- Knows detailed responsibilities required of position.
- Keeps updated and current (regulations, guidance, etc.).
- Understands and utilizes the company resource structure.
- Develops strategies and aligns work to achieve goals.
- Completes special projects and other duties as requested to
support needs of organization.
- Networks with co-workers to share best practices.
- Actively participates in the creation/modification of policies
- Organizes, plans, and manages time effectively to complete
- Completes mandatory training and courses required by completion
- Reports questionable situations, concerns, complaints or
- Understands the role of key performance indicators as they
relate to areas under audit.
- Develops accurate time budget/ forecast.
- Implements and ensures audit work conforms to professional
- Bases audit findings on systematic analyses and effect of
decisions on all areas of the company.
- Uses facts/data to completely understand the situation;
negotiates mutually-acceptable resolutions.
- Participates in the follow-up process to ensure resolution of
- Interprets the relative significance of issues needing
resolution; escalates at appropriate time.
- Efficiently plans, manages and audits to minimize resources in
- Works with Compliance Audit to develop regulatory audit
- Formulates audit programs to test current procedures; prepares
to document audit tests.
- Audits medical records and billing practices to monitor
compliance with applicable regulations.
- Prepares audits, studies, and other findings for the Compliance
- Utilizes resources to effectively and successfully execute
responsibilities of the position.
- Completes outpatient billing audit and other audits requiring
clinical and/or coding expertise. QUALIFICATIONS License or
- RN licensure required Minimum Qualifications:
- Minimum four years of experience with inpatient and/or
outpatient rehab preferred
- Associate's or Bachelor's degree in nursing or other clinical
- Master's degree in nursing or other clinical degree
- Knowledge of health care regulations and clinical terminology
- Knowledge of governmental reimbursement laws and regulations
- Working knowledge of auditing techniques and auditing standards
- Strong PC literacy (Microsoft Word and Excel, email) BENEFITS
Enjoy competitive compensation and benefits that start day one of
- Affordable medical, dental and vision plans provided to meet
the needs of full and part-time employees and their families.
- Generous paid time off that increases with tenure.
- Tuition reimbursement and continuing education
- Company-matching 401(k) and employee stock-purchase plans.
- Flexible spending and health savings accounts.
Shift: Day Job
Job ID: 2130385
Keywords: Encompass Health, Birmingham , Clinical Compliance Auditor, Accounting, Auditing , Birmingham, Alabama
Didn't find what you're looking for? Search again!