COMPLIANCE AUDITOR

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

Job summary

CenterLight Health System is seeking a Compliance Auditor in New York to strengthen the organization's compliance program through internal and external audits. You will develop audit plans, assess regulatory risks, and educate management on potential risks related to PACE, Part D, LHCSA, and Article 28 requirements.

The ideal candidate has a Bachelor's degree in a relevant field, at least three years of healthcare audit experience, and a solid understanding of Medicare and Medicaid.

Qualifications

• Bachelor's degree in business, finance, healthcare operations, or a clinical field.
• Minimum of three years of healthcare audit experience.
• Knowledge of Medicare and Medicaid programs.
• Billing and Coding experience preferred.
• Strong attention to detail and analytical skills.
• Willingness to stay current with regulatory requirements.

Responsibilities

• Conduct risk assessments and assist in the annual audit plan.
• Develop audit programs addressing risks and regulatory requirements.
• Assess control weaknesses via independent audits.
• Document audit work to support conclusions.
• Track results with action plan follow-up.
• Educate management on organization risks.
• Perform other duties as required by Compliance.

Skills

Attention to detail

Analytical skills

Statistical skills

Regulatory knowledge

Education

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

Tools

Billing/Coding experience

Job description

JOB PURPOSE: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 r esponsible 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: B achelor’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 PlanUnderstanding 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 - $100,000.00Every application is reviewed by our recruitment team. We do not use AI to make hiring decisions or automatically reject applicants. All employment decisions are based on job-related qualifications and applicable employment laws.