Job Summary

The Compliance and Risk Auditor supports the organization’s Compliance and Risk Management Programs by conducting audits, risk assessments, and monitoring activities to ensure adherence to healthcare laws, regulations, and internal policies. Working under the direction of the Compliance Officer, this position helps identify and mitigate areas of risk, supports process improvements, and promotes a culture of accountability and ethical behavior.

Job Responsibilities

• Conducts risk assessments and compliance audits for adherence to laws, regulations, and policies including HIPAA, the OIG Work Plan, Fraud Waste & Abuse, the Anti-Kickback Statute, Stark Law, Malpractice Risk Exposure Adjustment Program criteria. Identifies potential risks and works with leadership to implement corrective actions.
• Performs ongoing monitoring and tracking of compliance activities in designated software. Captures, maintains, and reports audit results and follow-up actions. Conducts smaller routine HIPAA audits and escalates findings as necessary.
• Prepares audit reports on audit findings, conclusions and recommendations for leadership. Prepares HIPAA breach notifications within required timeframe. Collaborates with department leaders to ensure timely completion of corrective action plans.
• Researches and interprets applicable federal, state, and local laws, regulations, and policies; prepares summaries and supports responding to compliance and risk inquiries and internal projects including annual review of department policies.
• Supports department education efforts by reviewing existing annual compliance training, creating new education, and assisting with presentations as needed.
• Monitors for regulatory and legal updates and communicates relevant changes to the Compliance Officer and leadership.
• Performs administrative tasks related to insurance and risk management, including preparing malpractice and liability claim forms and supporting documentation, managing annual insurance renewals, tracking invoices, coordinating depositions and processing criminal subpoena requests.
• Other duties as assigned by Compliance Officer.

Job Requirements

Education: Bachelor’s Degree with emphasis in Healthcare Administration, financing, or law.

Required Experience: 2 – 5 years’ experience.

Special Skills and Abilities:

• Strong understanding of healthcare compliance regulations (HIPAA, False Claims Act, OIG Work Plan, Stark, Anti-Kickback)
• Excellent analytical and writing skills
• Proficient in audit report documentation, project management, managing and tracking ongoing projects
• Ability to communicate effectively with leaders and staff
• High attention to detail, sound judgement, and problem-solving skills

Licensure/Certification/Registration: Healthcare Compliance, Internal Audit, or Coding Certification preferred.

Physical Requirements:

Populations Served

The age-specific populations with which the job incumbent interacts:

• No direct responsibility to treat or care for patients

Salary : $22 - $36