Compliance Audit Lead - Part-Time

Description

ScionHealth is recruiting for a Compliance Audit Lead to join our team! This is a PART-TIME role that is expected to work 20 hours per week. Remote candidates will be considered.

Job Summary

The Compliance Audit Lead supports ScionHealth as a part time, senior member of the Compliance function in a Compliance Audit leadership capacity. The role will manage the audit work plan, lead data analytics, participate in audit and monitoring, including review and direction of team member work product, and assist with ad hoc and special projects. The individual will be hospital billing and coding expert with proficiency in using relevant technology.

Essential Functions

• An individual must perform each essential function satisfactorily with or without reasonable accommodation.
• Leads moderate to high complexity projects of identified concerns with a focus on audit activities to address organization-specific risk.
• Assists the Compliance Audit Team in auditing and monitoring activities and in the timely completion of the annual Audit Work Plan.
• Partners with the Chief Compliance Officer and the Compliance Audit Team to successfully complete deliverables, fostering a culture of integrity and best practice adherence to organizational requirements and relevant government guidance and expectations (e.g., OIG and DOJ guidance, enforcement actions and advisory opinions).
• Leverages strong critical thinking and reasoning skills to assist the Compliance Audit Team in the identification, assessment, and remediation of corrective action plans and existing and emerging compliance risks.
• Conducts data analytics activity to enhance the ScionHealth Ethics and Compliance program.
  
  

Additional Information

• Serves both internal and external stakeholders including colleagues, patients, contractors, and vendors.
• Access to and/or works with sensitive and/or confidential information.
• Exhibits a fundamental awareness of healthcare regulations and compliance (e.g., False Claims Act, Stark Law, Anti-Kickback Statute, HIPAA, Medicare and Medicaid billing requirements, etc.).
  
  

Qualifications

Education

• Bachelor's degree or equivalent years of relevant experience required, Master’s degree in Healthcare or Business Administration, healthcare services, or another related field preferred.
  
  

License/Certification

• Certification in Coding (CPC, CCS) or Health Information (RHIA, RHIT) required; Compliance certification strongly preferred.
  
  

Experience

• 10 years hospital inpatient/outpatient coding experience.
• Experience in healthcare auditing and internal controls review.
  
  

Knowledge/Skills/Abilities

• Knowledgeable in healthcare billing regulations and coding guidelines (CPT, ICD-10, HCPCS).
• Strong understanding of the healthcare revenue cycle.
• Analytical and problem-solving skills to identify the root cause of compliance risks and trends in billing data.
• Excellent communication skills to educate and articulate compliance concerns.
• Detail-oriented with strong problem-solving skills.
• Flexible, innovative, and committed team player.
• Well-organized, highly motivated project manager: Sets personal goals and determines how to achieve results with limited direction; prioritizes and leads multiple complex projects and other workstreams simultaneously.
• Approximate percentage of time required to travel: Limited – up to 10%
• Depending on a candidate's qualifications, this role may be filled at a different level.