Healthcare Compliance & Risk Auditor

Provider Network Solutions, LLC; Miami (FL); On-site; USD 70,000 - 110,000; Full time

Job summary

Provider Network Solutions, LLC is seeking a Compliance Auditor to review business practices and enforce healthcare regulations. Role includes auditing, reporting findings, and driving corrective actions in collaboration with the Compliance Officer.

Candidates should have 3–5 years in operational audits or regulatory compliance, with knowledge of Medicare/Medicaid rules. Strong communication, analytical, and organizational skills are essential.

Qualifications

• Bachelor’s degree preferred; 3–5 years in operational audits or regulatory compliance.
• Healthcare regulations knowledge including Medicare/Medicaid.
• Bilingual abilities preferred.
• Compliance certification is desirable.
• Experience with audits and monitoring processes.

Responsibilities

• Promote a strong code of ethics and integrity.
• Stay abreast of healthcare laws, regulations and standards, including Medicare, Medicaid and Commercial regulations.
• Assist in risk/issue identification and remediation within audits and delegation oversight audits.
• Resolve compliance issues identified through audits, coordinating with department leaders.
• Monitor quality of audited processes and mitigate risks with the Compliance Officer.
• Analyze, organize and document findings from audits, prepare reports and CAPs.
• Conduct internal audits and present results to the Compliance Officer.
• Handle external audits, manage data collection, dissemination and closure notices.
• Maintain organized audit records and CAPs log.
• Provide training and guidance on compliance matters.

Skills

Bilingual

Regulatory knowledge

Presentation skills

Communication skills

Analytical skills

Attention to detail

Time management

AI knowledge

Education

Bachelor's degree preferred

Tools

Microsoft Office

Job description

Provider Network Solutions, LLC is seeking a Compliance Auditor to review business practices and enforce healthcare regulations. Role includes auditing, reporting findings, and driving corrective actions in collaboration with the Compliance Officer.

Candidates should have 3–5 years in operational audits or regulatory compliance, with knowledge of Medicare/Medicaid rules. Strong communication, analytical, and organizational skills are essential.