at memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of the memorial experience.
summarythe compliance auditor is responsible for implementing and promoting memorial’s compliance audit plan to assist the director of compliance in reviewing and ensuring compliance with federal and state laws while affirming organizational commitment to honesty and integrity in all phases of corporate conduct and to assist executive management by performing compliance audits based on the annual compliance work plan and the special requests of the chief executive and other administrative officers.
responsibilitiesresponds to formal inquiries to the compliance hotline to ensure compliance with all laws, regulations, stated policies and procedures. Responds to formal inquiries from other departments within the system to ensure compliance with all laws, regulations, stated policies and procedures. Participates in investigations and responds to questions, issues, reports and formal inquiries by federal and state agencies of possible violations or non-compliance matters raised by employees, patients, physicians and the public.
Assesses and, if necessary, investigates and responds to formal inquiries by federal and state agencies as well as matters of non-compliance raised by employees, patients, physicians and the public. The compliance auditor is responsible for conducting audits of the system’s compliance with laws and regulations established by the centers for medicare and medicaid services and the agency for health care administration.
The compliance auditor is expected to examine and analyze patient medical records to confirm that documentation supports medical necessity, appropriateness of services provided, coding and the services charged and billed. The compliance auditor assists in monitoring compliance with state and federal laws and the system's policies and procedures to identify deviations and recommend corrective action to the system's chief executive officer.
Audits are performed in accordance with accepted standards and reports all pertinent findings based on the outcome of the audit. The compliance auditor prepares formal written audit reports for executive management that include audit methodology, findings of any deviations, inaccuracies or irregularities, and recommendations to correct identified non-compliance. The compliance auditor provides the chief compliance and internal audit officer with written reports of findings and recommendations on a timely basis.
The compliance auditor interacts with legal counsel to discuss the organization's initiatives on regulatory compliance. The compliance auditor monitors audit recommendations and retests departments that were previously audited using a smaller sample of transactions to ensure that recommended changes have been implemented and are effective. The compliance auditor communicates with and educates employees on the memorial healthcare system (mhs) compliance program.
The auditor assists in providing employee training seminars in accordance with the compliance policy on employee training policies and procedures. The auditor achieves and maintains proficiency in federal and state regulations; attends seminars; compiles and analyzes laws, regulations and interpretive materials. Meets and participates in quarterly compliance working committee to ensure that the compliance process is functioning as required.
accountability, analysis and decision making, customer service, effective communication, healthcare industry, measuring results, problem solving, responding to change, standards of behavior
education and certification requirementsbachelors: nursing (required) registered nurse compact license (rn license compact) - compact rn multistate, registered nurse license (rn license) - state of florida (fl)
additional job informationcomplexity of work: this role requires critical thinking skills, effective communication including public speaking and written…
(If this job is in fact in your jurisdiction, then you may be using a Proxy or VPN to access this site, and to progress further, you should change your connectivity to another mobile device or PC).