COMPLIANCE AUDITOR

C2Q Health Solutions; New York (NY); On-site; USD 90,000 - 100,000; Full time

Job summary

CenterLight is seeking a Compliance Auditor to promote adherence to federal, state, and local laws across PACE, Part D, LHCSA, and Article 28 requirements via auditing. The role supports the Compliance Department's internal and external audit functions and helps strengthen risk management.

The position emphasizes regulatory expertise, plan development, and ongoing education for leadership while maintaining up-to-date regulatory knowledge to minimize organizational risk.

Qualifications

• Bachelor's degree in a relevant field is required.
• Minimum of three years in healthcare audit is preferred.
• Strong understanding of Medicare and Medicaid programs is advantageous.

Responsibilities

• Develop audit programs to address risks and evaluate regulatory compliance.
• Assess control weaknesses via independent audits and document audit work.
• Use information effectively to support a viable position.
• Be available to help others solve problems and collaborate.
• Measure and track audit results through action plan follow-up.
• Maintain knowledge of governmental regulations and educate management as needed.
• Perform other duties aligned with the Compliance department's goals.

Skills

Regulatory knowledge

Auditing

Analytical skills

Attention to detail

Healthcare industry experience

Education

Bachelor's degree in business, finance, health care operations, or a clinical field

Job description

The Compliance Auditor will foster an environment that enhances and promotes compliance and adherence to all relevant federal, state, and local laws, rules, and regulations applicable to PACE, Part D, LHCSA, and Article 28 requirements, etc., through audits. The Compliance Auditor is responsible for performing internal and external auditing functions for the Compliance Department of CenterLight.

Job Responsibilities

The Compliance Auditor utilizes regulatory expertise to conduct effective risk assessments and assist in preparing an annual audit plan.

• Develop comprehensive audit programs to address risks and evaluate compliance with governmental or other regulatory requirements.
• Assess control weaknesses by conducting independent audits according to the annual audit plan and develop appropriate documentation to support audit work performed.
• Use information effectively to support a viable position.
• Make self-available to help others solve problems.
• Measure and track results of audits performed through action plan follow-up.
• Maintain current knowledge base of governmental and regulatory requirements and provide education to management and governance as needed concerning organization risks and their potential impact.
• Perform other duties as required, consistent with the goals, objectives, and responsibilities of the Compliance department.

Qualifications

Education: Bachelor's degree in business, finance, health care operations, or a clinical field required.

Experience

• Minimum of three (3) years of Healthcare Audit background preferably in a Health Insurance Plan
• Understanding of Medicare and Medicaid programs is strongly preferred.
• An in-depth understanding of the industry's rules, guidelines, and regulations.
• Billing and Coding experience, preferred.
• Strong attention to detail, and analytical, and statistical skills.

Disclaimer

Responsibilities and tasks outlined in this job description are not exhaustive and may change as determined by the needs of the company.

We are an affirmative action and equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, height, weight, or genetic information. We are committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities.

Salary Range (Min-Max)

$90,000.00 - $100,000.00