Job Information
Oak Orchard Health Healthcare Compliance Auditor in Brockport, New York
Healthcare Compliance Auditor
Brockport, NY (http://maps.google.com/maps?q=300+West+Avenue+Brockport+NY+USA+14420) • Compliance & Risk
Description
Do you want to be part of a leading, patient-centered organization where professionals come together to improve access to quality health care for all? At Oak Orchard Health, you can grow your career with the fulfilment and satisfaction of knowing that your work is making a difference in someone’s life. We have 8 medical offices located in communities throughout Western NY and we continue to expand and recruit top talent with our mission to ensure everyone has access to affordable, quality health care. Our diverse, highly skilled professionals are the reason for our success, from physicians to nurses to administrators and support personnel. If you’re passionate about serving all with excellence, equity, inclusion, respect, and dignity, we think you’ll fit right in!
We offer:
-Tuition Reimbursement and Student Loan Forgiveness (PSLF) Eligible!
-Flexible schedule that promotes a healthy work life balance!
-Competitive wages!
-Comprehensive benefit package (health/vision/dental) that starts the first of the month after your hire date!
-Retirement Plan 403(b) with a competitive company match
-Organizational support of continuing education and professional development!
-Company paid life Insurance!
-Generous PTO package that includes Vacation time, Sick time, Personal Days, Floating Holidays, and Company paid holidays!
The Healthcare Compliance Auditor is responsible for investigating medical service providers and staff to ensure that they meet all legal requirements, review clinical documentation, and identifying potential problems that could create regulatory issues in the future. Since healthcare laws change frequently, this position is responsible for keeping the organization informed about new rules and help them change practices to remain compliant.
Job Responsibilities:
Investigate and monitor Medical identity theft (physicians and other providers)
Monitor and investigate Medicare Fraud, Waste, and Abuse – 3rd party vendors, records requests, writing reports and investigating, and report to state and feds.
Works with Compliance team on annual GRC assessments, staff and patient surveys, PDSAs and other compliance tools
Monitor SPHER platform to ensure compliance, conduct HIPAA violation investigations
Audit, create and maintain documentation in support of; CMS mandated audits and OSHA
Maintain tickler files for safety and facility requirements
Streamline processes for auditing of patient records
Prepare, select and audit medical records monthly to ensure accuracy and compliance in our EHR systems.
Monitor billing and compliance processes
Develop and implement systems to maintain records for mandatory compliance training, drills, equipment etc. assists and deliver training
Staying apprised of the DHHS/CMS regulations and guidelines on the Federal level, relative to FQHCs and on the state level relative to D&TCs – Article 28 regulations.
Requirements
Skills / Qualifications:
High level of attention to detail and critical/analytical thinking
Must be self-directed and escalate concerns with potential solutions
Proficiency in Microsoft Office Suite and other healthcare software tools
Strong written and verbal communication
Excellent organizational skills and priority setting
Ability to present to staff and vendors
Ability to work cooperatively with various departments, and
Treat confidential information with discretion
Education / Experience:
Associates Degree in Business or related field, or public/private payor background preferred.
Licensed Healthcare Auditor (LHA or CPMA) or willing to obtain within the first 12 months of hire
Minimum of 5 years’ experience in healthcare, health insurance, enrollment/claims processing; with proficient knowledge of public as well as private third party payors preferred.
Comprehensive Benefits:
Health / Dental /Vision Insurance
Retirement Plan
Tuition Reimbursement
Public Service Loan Forgiveness
Generous Time Off
Salary Description
$70,000-$75,000