Healthcare Internal Auditor

Summary

Jupiter Medical Center is a healthcare organization serving patient needs in Palm Beach County and the greater Treasure Coast. The Healthcare Internal Auditor conducts risk assessments, develops and performs audits, evaluates regulatory compliance, prepares reports and action plans, and assists with administering the Corporate Compliance Program.

Responsibilities

• 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

Skills

• 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
• At least three (3) years healthcare Audit or Compliance background
• 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
• 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)
• Able to work under a stressful environment, work independently, capable of making sound decisions, be detail oriented, alert, and self-motivated
• Maintenance of required professional licensing and/or certification(s)
• 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)
• Clinical (RN, LPN, CAN, CMA) credential a plus but not required

Qualifications

Must Haves

• 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
• At least three (3) years healthcare Audit or Compliance background
• 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
• 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)
• Able to work under a stressful environment, work independently, capable of making sound decisions, be detail oriented, alert, and self-motivated
• Maintenance of required professional licensing and/or certification(s)

Nice to Haves

• 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)
• Clinical (RN, LPN, CAN, CMA) credential a plus but not required