Healthcare Compliance Auditor & Risk Analyst

Provider Network Solutions LLC; United States; Sur place; USD 70 000 - 90 000; Plein temps

Résumé du poste

Provider Network Solutions LLC is seeking a Compliance Auditor to lead reviews of business practices and enforce applicable federal and state regulations, client contracts, and internal policies. The role involves conducting internal and external audits, interviewing executives, and recommending improvements to address root causes of non-compliance.

You will analyze findings, prepare reports, monitor corrective action plans, and partner with department leaders to ensure timely, effective

Qualifications

• Bilingual, written and spoken (preferred).
• Bachelor's degree preferred.
• 3-5 years' experience in operational audits, regulatory compliance or government regulations.
• Knowledge in Healthcare industry preferred.
• Medicare, Medicaid, and Commercial Regulations knowledge.
• Relevant experience in law, ethics, organizational business, finance, or statistical analysis.
• Experience in Audits and Monitoring processes.
• Compliance Certification is strongly desired.

Responsabilités

• Promote a strong code of ethics and integrity.
• Stay abreast of changes in healthcare laws, regulations and standards, including Medicare/Medicaid/Commercial requirements.
• Assist in risk/issue identification and remediation within audits.
• Resolve compliance issues identified through audits, coordinating with department leaders.
• Monitor the quality of audited processes across departments with compliance oversight.
• Analyze, document findings, and prepare corrective action plans.
• Conduct internal audits, develop quality indicators and present results.
• Oversee external audits, coordinating samples, notices, and data preparation.
• Maintain organized audit records within the systems.
• Address CAPs and ensure evidence of completion is provided on time.
• Maintain the CAPs log and related evidence.
• Adhere to policies to support the Compliance Program.
• Provide training and guidance on compliance matters.
• Perform other duties as required.

Connaissances

Microsoft Office

Presentation skills

Verbal and written communication

Regulatory writing

Research and analytical skills

Business requirements understanding

Time management

AI knowledge

Formation

Bachelor's degree preferred

Description du poste

Provider Network Solutions LLC is seeking a Compliance Auditor to lead reviews of business practices and enforce applicable federal and state regulations, client contracts, and internal policies. The role involves conducting internal and external audits, interviewing executives, and recommending improvements to address root causes of non-compliance.

You will analyze findings, prepare reports, monitor corrective action plans, and partner with department leaders to ensure timely, effective