Job details

Compliance Auditor

ChristianaCare is searching for a Compliance Auditor to support the Office of Compliance & Privacy through assigned compliance activities and audits to ensure effective documentation. Through communication and training activities, they provide information or clarification on audit results, compliance inquiries, documentation standards, guidelines, and regulatory requirements. They provide operational, technical, and auditing support for the Office of Compliance & Privacy.Education and experience requirements:Bachelor’s Degree is required.Equivalent of 5+ years’ experience in nursing, compliance auditing, clinical chart reviews, medical necessity review/auditing, revenue integrity, and/or compliance department operations/regulationsCertification (at least one of the following are required and are to be maintained as a condition of employment)Certified in Healthcare Compliance (CHC); Certified in Healthcare Privacy Compliance (CHPC)In-depth knowledge of compliance and privacy regulationsMust be proficient in CMS Conditions of Participation, CMS Conditions of Payment, and Inpatient and Outpatient Prospective Payment System. Strong analytical and communication skills.Candidates who do not hold a CHC will be given consideration but will need to obtain the CHC within 2 years of their hire date with the company.Experience in compliance and privacy auditing techniques and methods preferred, but not requiredPrincipal duties and responsibilities:Helps the Office of Compliance & Privacy adhere to assigned audit schedule and reviews as outlined in the Departmental Compliance WorkplanAssists with reviewing internal and external inquiries regarding compliance and privacy matters, including government and third-party payor requests.Conducts audits and focused reviews to ensure compliance with government and payor guidelines.Assists with maintaining regular and consistent governance-level reporting and metrics for the Compliance department, including but not limited to dashboards, board reporting, weekly, monthly, and annual compliance & ethics reporting.Reviews documentation to ensure appropriate assignment of facility-based and provider-based clinical documentation and medical necessity,Maintain a working knowledge of HIPAA and CMS regulations.Participate in the planning and scheduling of compliance projects.Research compliance related questions upon request from departments and/or practices.Identify and report potential audit and compliance risks.Special requirements:Must maintain current CCB certificationWhen you become an employee at ChristianaCare, you are joining a robust healthcare organization that truly cares about their patients and their caregivers. For the second consecutive year, Forbes magazine has ranked ChristianaCare as one of the best large health systems to work for in the United States! Guided by excellence and love, our Caregivers enjoy a multitude of employee benefits that include:Full Medical, Dental, Vision and other insurance benefits403 (b) with an employer matchDiverse and Inclusive cultureGenerous paid time off with annual roll-over and opportunities to cash out12 week paid parental leaveAbout Christiana Care:Headquartered in Wilmington, Delaware, ChristianaCare is one of the country’s most dynamic health systems, centered on improving health outcomes, making high-quality care more accessible and lowering health care costs. ChristianaCare includes an extensive network of outpatient services, home health care, medical aid units, two hospitals (1,227 beds), a Level I trauma center and a Level III neonatal intensive care unit, a comprehensive stroke center and regional centers of excellence in heart and vascular care, cancer care and women’s health. ChristianaCare is a not-for-profit teaching health system with more than 260 residents and fellows. We are continually ranked by US News & World Report as a Best Hospital. With our unique, data-powered care coordination service and a focus on population health and value-based care, ChristianaCare is shaping the future of health care.

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$75000 / YEARLY (est.)

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$65000K

$85000K

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What You Should Know About Compliance Auditor, ChristianaCare

Are you ready to make a difference in healthcare compliance? ChristianaCare is on the lookout for a passionate and knowledgeable Compliance Auditor to join our Office of Compliance & Privacy in Elsmere, DE. As a Compliance Auditor, you'll play a crucial role in supporting our teams through various compliance activities and audits, ensuring that our documentation is top-notch. You’ll engage with colleagues and share your insights through effective communication and training sessions, helping to clarify audit results and compliance inquiries while adhering to regulatory requirements. The right candidate will have a Bachelor's Degree and at least 5 years of experience in nursing or compliance-related fields. If you have certifications like the Certified in Healthcare Compliance (CHC), that's even better! You'll conduct audits, assist with internal inquiries, and ensure we meet all compliance standards. But it’s not just about the work—you’ll be part of a dynamic, supportive environment that values your contributions. And as you grow in your role, ChristianaCare offers you a fantastic array of benefits, including comprehensive health coverage and paid parental leave. If you're passionate about compliance and privacy in healthcare and want to build a career in a team that truly cares, we want to hear from you!

Frequently Asked Questions (FAQs) for Compliance Auditor Role at ChristianaCare

What are the primary responsibilities of a Compliance Auditor at ChristianaCare?

As a Compliance Auditor at ChristianaCare, your main responsibilities include conducting audits and focused reviews to ensure adherence to government and payer guidelines, assisting with internal and external compliance inquiries, and maintaining governance-level reporting for the Compliance department. You'll also participate in the planning and scheduling of compliance projects, making sure our operations align with standards in place.