Auditing Director executes a comprehensive enterprise-wide internal auditing strategy, function, and practice adhering to auditing standards and regulatory requirements. Uses auditing governance frameworks and procedures to plan and manage the auditing schedules, projects, teams, and tasks required to meet defined objectives. Being an Auditing Director engages with other functions across the enterprise, like risk, finance, information technology, and security, to facilitate audits. Prepares audit reports and recommends enhanced controls or processes as needed. Additionally, Auditing Director builds auditing teams and expertise with coaching and developmental initiatives. Requires a bachelor's degree. Typically requires a Certified Public Accountant (CPA). May sometimes require Certified Internal Auditor (CIA). Typically reports to a director. The Auditing Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. To be an Auditing Director typically requires 3+ years of managerial experience. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. (Copyright 2024 Salary.com)
This role integrates auditing with a comprehensive knowledge of denials management to evaluate current compliance programs and processes, and to assist with effecting change as necessary to maintain and improve regulatory compliance and reimbursement across service lines. This VP audits and provides recommendations to continually improve Company processes, programs and systems designed to address compliance issues related to surveys by payors, state, and federal programs, and to ensure Company staff is billing and documenting appropriately. This role oversees and collaborates on the development of compliance related data analytics, business intelligence, and other automated systems to support the organization’s Corporate Compliance Plan. This VP fosters process refinement associated with reimbursement, regulatory, and other compliance initiatives within the organization. This role includes supervision of 1 direct report.
Reports To: SVP of Regulatory and Compliance
Knowledge, Skills, and Experience Required
Qualifications Bachelor’s Degree (4) years proven experience in a compliance role in the healthcare industry – REQUIRED including ADR-denials management, CPT and ICD-10 coding
Physical Demands
Someone performing these duties should be in good physical condition and possess the capabilities, with or without reasonable accommodations.
Work Environment
This job operates remotely in the associate’s home office with field travel to support compliance team initiatives as assigned. This role routinely uses standard office computer equipment such as laptops, software programs, etc.
Position Type/Expected Hours of Work
This is a full-time salaried position. Some flexibility in specific work hours is allowed, and must work required hours each week to maintain full-time status.
Travel
Must be willing to travel overnight as needed.
HIPAA & THE MINIMUM NECESSARY STANDARD
The Employee shall maintain the confidentiality of all protected health information (PHI) whether electronic, written or oral to which he/she may be exposed either during the course of their duties or the result of an incidental disclosure. In accordance with the minimum necessary standard, the employee may only access PHI to perform the job as a Senior Vice President Quality Assurance & Compliance. The minimum necessary standard must be applied in all matters and shall continue privacy protection during non-working hours and after employment is no longer with the company.
Other Duties
This job description does not list all the duties of the job. You may be asked by the supervisors or managers to perform other duties. You will be evaluated in part based upon your performance of the tasks listed in this job description.
EEO Statement
HealthPRO Heritage and its subsidiaries provide equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, HealthPRO Heritage and its subsidiaries comply with applicable state and local laws governing nondiscrimination in employment in every location in which the company facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
Principal Responsibilities and Duties