Be at your best with an organization that equips you to do so. Whose people unite in making lives better. At Carilion Clinic, we help communities stay healthy and our region grow stronger through compassionate care, medical education and research, and neighborhood outreach. As part of our team you can expect professional stability, strong technological resources, and the advancement potential of a regional leader.
Based in Roanoke, VA, we are an award-winning, community-based network of hospitals, primary and specialty physician practices, and affiliations with prestigious academic medical institutions. Explore how joining a regional leader can enhance your ability to learn, grow, and succeed.
The Compliance Auditor will be responsible for providing organizational integrity and compliance guidance, developing and implementing proactive strategies to reduce risk and performing investigations and audits for the areas assigned. The auditor will focus the majority of their time on performing planned and investigative audits and associated work related to revenue-cycle related compliance risks.
1. As assigned, receives, provides guidance, investigates and responds to documentation, coding and revenue-cycle related organizational integrity and compliance questions and concerns. Will assist in the evaluation and resolution of external audit inquiries and results (such as RAC, CERT, PERM, ZPIC, CMS, MAC, etc.).
2. Assists with periodic risk assessments to identify, prioritize and evaluate integrity/compliance risks.
3. Assists with the development and maintenance of integrity/compliance policies, forms, notices and associated materials to reflect organizational processes and well as compliance with applicable laws and regulations.
4. Develops implements and/or monitors mitigation plans resulting from integrity/compliance events/risks.
5. Performs compliance awareness and training initiatives and promotes such awareness throughout the organization.
6. Performs audits to determine if the organization is complying with its policies, procedures and applicable regulatory standards. Collaborates with impacted parties to develop and implement action plans to address audit findings.
7. Assists in preparation of reports.
8. Fully documents activities in the designated databases.
9. Collaborates and coordinates with key stakeholders when performing assigned job duties. Includes partnering with assigned departments, locations, programs and/or service lines to address unique integrity/compliance risks and provide general integrity/compliance visibility and support.
10. Assists the Organizational Integrity& Compliance leadership and senior compliance auditors with other duties as assigned.
11. Maintains current knowledge of applicable federal and state laws and regulations, and monitors advancements in risk mitigation strategies to ensure organizational adaptation and compliance.
Education: Associates Degree or 7 years relevant experience required.
Experience: Minimum of two years coding, documentation and revenue cycle compliance, auditing or applicable experience.
Licensure/Certification: Coding certification required for applicable area of expertise at time of hire (e.g. CPC, COC, CIC).Certification in Healthcare Compliance (CHC) required at time of hire or within 18 months of the date of hire.
Other: Excellent oral and written communications skills. Demonstrated knowledge of providing adult education, business practices, with ability to work with minimal supervision, and adapt quickly to change. A skilled in use of personal computers to aid productivity and enhance output.
Below are our core values that we strive to embody and expect of all our team members:
CommUNITY: Working in unison to serve our community, our Carilion family and our loved ones.
Courage: Doing what’s right for our patients without question.
Commitment: Unwavering in our quest for exceptional quality and service.
Compassion: Putting heart into everything we do.
Curiosity: Fostering creativity and innovation in our pursuit of excellence.