Compliance Auditor and Consultant Sr

Ann & Robert H. Lurie Children’s Hospital of Chicago provides superior pediatric care in a setting that offers the latest benefits and innovations in medical technology, research and family-friendly design. As the largest pediatric provider in the region with a 140-year legacy of excellence, kids and their families are at the center of all we do. Ann & Robert H. Lurie Children’s Hospital of Chicago is ranked in all 10 specialties by the U.S. News & World Report.

Location

Olympia Center

Job Description

Under the direction of the Compliance Audit Director, the Senior Compliance Auditor and Consultant supports the development of the annual Compliance Audit Plan and performs audits in accordance with the Plan. These audits provide insight into processes, internal controls, and risk. The Senior Compliance Auditor and Consultant provides education in follow up to audit findings. Under the direction of the Chief Compliance and Integrity Officer, the Senior Compliance Auditor and Consultant provides compliance guidance and otherwise collaborates with stakeholders throughout the organization to prevent, detect, and resolve internal legal and regulatory risk and to promote ethical business practices.

Job Responsibilities:

• Assists in the identification of compliance risk areas requiring audit, review, and education.
• In accordance with the Compliance Audit Plan, designs and conducts audits to aid in the compliance with various regulatory requirements, which may include coding and billing rules set forth by Medicaid, Medicare, and commercial payers.
• Serves as a collaborative resource to the Medical Center’s leadership, employees, medical staff, and others on compliance-related topics and issues.
• Analyzes data and trends to determine audit risk areas and appropriate audit sample selection.
• Assesses the effectiveness of and compliance with internal policies and procedures, including internal controls.
• Ensures adequate documentation of audit findings and recommendations.
• Prepares and presents concise reports of audit results with practical recommendations to improve controls and processes where needed.
• Develops and provides education to clinical, coding, and department staff regarding requirements for accurate billing, coding, and clinical documentation. Education may be in relation to audit findings or may be proactive, such as in response to new or updated regulations or guidance.
• Follows up on the status of outstanding audit issues and validates that corrective action plans were developed and implemented in response to audit recommendations when applicable.
• Collaborates at all levels to resolve billing and documentation issues and uses professional judgment and external sources to research and resolve issues that are not clearly defined.
• Monitors updates to Medicaid and other payer regulations and coding and billing guidelines and assists colleagues in developing and providing education and strengthening policies and processes.
• Assists in developing and implementing Compliance Audit policies and procedures to support audit and investigation processes and standards.
• Contributes to internal compliance-related committees and other meetings in support of the Compliance and Integrity Program.
• Maintains a personal presence that is characterized by a sense of honesty, integrity, and caring.
• Other job functions as assigned.
  
  

Education and Experience:

• Relevant bachelor's degree or other demonstrable knowledge and understanding of the health care industry’s regulatory environment.
• At least five-to-seven years of experience in a hospital setting (experience with APR DRG's/ICD-10-PCS) or facility coding audit role assessing compliance with government and third-party payer coding and documentation requirements. Must have experience providing individual and group education sessions with clinicians, technicians, and other stakeholders on how to improve compliance with billing and coding requirements.
• One of the following certifications is required: Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA).
• Demonstrated knowledge of healthcare regulatory compliance.
• Analytical skills necessary to collect information from diverse sources, apply professional principles in performing analyses and testing, and summarize the information to determine and document conclusions.
• Proficient with Microsoft Office applications, including SharePoint, Outlook, Excel, Word, and PowerPoint.
• Knowledge of Epic system preferred.
• Strong written and verbal communication skills; able to effectively and collegially deal with conflicting views and mediate fair solutions.
• Strong time management skills; able to manage multiple projects and deadlines simultaneously with self-direction.
• Must be comfortable operating in a collaborative, shared leadership environment.
  
  

Education

Bachelor's Degree (Required)

Pay Range

$93,600.00-$154,440.00 Salary

At Lurie Children’s, we are committed to competitive and fair compensation aligned with market rates and internal equity, reflecting individual contributions, experience, and expertise. The pay range for this job indicates minimum and maximum targets for the position. Ranges are regularly reviewed to stay aligned with market conditions. In addition to base salary, Lurie Children’s offer a comprehensive rewards package that may include differentials for some hourly employees, leadership incentives for select roles, health and retirement benefits, and wellbeing programs. For more details on other compensation, consult your recruiter or click the following link to learn more about our benefits.

Benefit Statement

For full time and part time employees who work 20 or more hours per week we offer a generous benefits package that includes:

Medical, dental and vision insurance

Employer paid group term life and disability

Employer contribution toward Health Savings Account

Flexible Spending Accounts

Paid Time Off (PTO), Paid Holidays and Paid Parental Leave

403(b) with a 5% employer match

Various voluntary benefits:

• Supplemental Life, AD&D and Disability
• Critical Illness, Accident and Hospital Indemnity coverage
• Tuition assistance
• Student loan servicing and support
• Adoption benefits
• Backup Childcare and Eldercare
• Employee Assistance Program, and other specialized behavioral health services and resources for employees and family members
• Discount on services at Lurie Children’s facilities
• Discount purchasing program
  
  

There’s a Place for You with Us

At Lurie Children’s we embrace and celebrate diversity and equity in a serious way. We are committed to building a team with a variety of backgrounds, skills, and viewpoints — recognizing that diverse identities strengthen our workplace and the care we can provide to the Chicago community and beyond. We treat everyone fairly, appreciate differences, and make meaningful connections that foster belonging and allyship. This is a place where you can be your best, so we can give our best to the patients and families who trust us with their care.

Lurie Children’s and its affiliates are equal employment opportunity employers. We value diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity or expression, religion, national origin, ancestry, age, disability, marital status, pregnancy, protected veteran status, order of protection status, protected genetic information, or any other characteristic protected by law.

Support email: candidatesupport@luriechildrens.org