Healthcare Internal Auditor

Jupiter Medical Center Physicians Group, Inc.; United States; On-site; USD 70,000 - 100,000; Full time

Job summary

Jupiter Medical Center Physicians Group, Inc. seeks an experienced Healthcare Internal Auditor to join the Compliance Department. The role focuses on conducting risk assessments, developing audit programs, and ensuring adherence to governmental and accreditation standards.

Responsibilities include evaluating controls, preparing reports, and collaborating with management to implement corrective actions. A strong regulatory background and EMR familiarity are preferred.

Qualifications

• Bachelor's degree in business, finance, health care operations, or a clinical field.
• Substantial work-related experience as an auditor may substitute academic credentials.
• At least 3 years healthcare audit or compliance experience in provider or payor environment.

Responsibilities

• Develop comprehensive audit programs to address risks and evaluate compliance with governmental or regulatory requirements.
• Assess control weaknesses by conducting independent audits according to the annual audit plan and document audit work.
• Prepare reports and work with management to develop action plans.
• Maintain knowledge of governmental/regulatory requirements and educate management accordingly.
• Participate in training and education programs related to state and federal laws and accreditation standards.

Skills

Auditing

Regulatory compliance

Data analysis

HIPAA knowledge

EMR experience

Education

Bachelor's degree in business/finance/health care operations/clinical field

Tools

Excel

EMR systems

Word

PowerPoint

Job description

Ranked #1 for Safety, Quality and Patient Satisfaction, Jupiter Medical Center is the leading destination for world-class health care in Palm Beach County and the greater Treasure Coast. Outstanding physicians, state-of-the-art facilities, innovative techniques and a commitment to serving the community enables Jupiter Medical Center to meet a broad range of patient needs. Jupiter Medical Center is the only hospital in Palm Beach, Martin, St. Lucie and Indian River counties to receive a 4-star quality and safety rating from the Centers for Medicare & Medicaid Services (CMS).

Education

• Bachelor's degree in business, finance, health care operations, or a clinical field
• Substantial work-related experience as an auditor, along with academic credentials, may serve as a substitute.

Experience/Qualifications

• At least three (3) years healthcare Audit or Compliance background, preferably in healthcare provider or payor, clinical coding, or revenue cycle environment.
• Experience in use of the electronic medical record (EMR) preferred.
• Ability to interpret and apply Medicare and Medicaid documentation and coding rules and regulations.
• Proficiency Word, Excel, Power Point required. This position will be required to regularly generate and manipulate data in Excel.
• Clinical (RN, LPN, CAN, CMA) credential a plus but not required.
• Excellent organization skills
• Understanding of national and state laws and regulations including but not limited to:
  • False Claims Act
  • Physician Self-Referral (Stark) Anti-kickback statute
  • Health Insurance Portability Act (HIPAA)
  • Health Information Technology for Economic and Clinical Health (HITECH)

Position Summary

The Healthcare Internal Auditor utilizes regulatory expertise to conduct effective risk assessments and assist in preparing annual audit plan. As this position is a member of the Compliance Department this role will be responsible for, in addition to Internal Auditing, assisting the Compliance Officer in administering the Corporate Compliance Program.

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.

Prepare reports and work with management to develop action plans that are suitable for the organization.

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 organizational risks and their potential impact.

Maintaining databases and reporting processes managed by the Compliance Department.

Participates in the analysis, design/revision, and delivery of compliance-related training and education programs with respect to state law, federal law, and accreditation standards along with policies and procedures. This may include scheduling of training sessions and maintenance of training records, and assisting in developing training modules, where needed.

Assists in the preparation of documents for the internal Compliance Committee meetings and Audit Committee meetings.

Assists in the development, initiation, maintenance and revision of departmental policies and procedures, workflows, and related activities.

Perform other duties as assigned.

Team Member Competencies

Establishing Relationships

Builds effective networks, working relationships, and alliances in order to collaborate effectively within department and organization. Can relate to all kinds of people regardless of background; find topics and common interests that can be used to build rapport with others.

Peer Support

Provides guidance and feedback to help others strengthen knowledge/skills needed to accomplish tasks, solve problems, and perform effectively within the team.

Inspiring and Motivating Others

Fosters commitment and cohesiveness by facilitating cooperation and working as a team within the organization toward goal accomplishments. Work well with others, build consensus, and ensure cooperation to complete tasks and positive workflow.

Demonstrating Emotional Intelligence

Exercises self-leadership, self-awareness, and self-regulation; manages emotions so that they are expressed appropriately; leads others by showcasing adaptability, empathy, and social skills.

Acting with Integrity

Interacts with others in a way that is seen as direct and truthful; ensures confidence in individual and organizational motives and representations. Acts in a way that is consistent with personal and organizational values by keeping confidence, promises, and commitments. Clearly states goals and beliefs; informs people of their true intentions, does what they say they will do; follows through on commitments.

Being a Champion for Change and Innovation

Supports people in their efforts to try new things. Thinks creatively, generates novel and val ...