Internal Auditor - Hybrid

$66,000 - $105,000/Yr

Valley Health System - Oneonta, NY

Full-time

Oneonta, NY

Religious, Grantmaking, Civic, Professional, and Similar Organizations

About the position

The Internal Auditor - Compliance will oversee compliance audits for the Mohawk Valley Health System (MVHS) under the guidance of the Chief Compliance Officer. This role is crucial in assessing and enhancing the effectiveness of the compliance program, identifying audit areas based on regulatory guidelines and risk factors, and implementing corrective action plans in collaboration with various departments.

Responsibilities

• Plan, execute and report on compliance audits across various functions and departments within MVHS.
• Review and analyze processes and policies to ensure alignment with regulatory requirements and internal standards.
• Identify potential areas of compliance risk and assess their impact on the organization.
• Develop and implement risk assessment strategies to mitigate identified risks.
• Assist in the development, communication, and enforcement of policies and procedures system-wide.
• Develop and deliver compliance training based on identified audit findings.
• Prepare detailed audit reports and presentations, outlining findings, recommendations, and compliance status in collaboration with the Chief Compliance Officer.
• Work closely with internal teams, including Legal, Risk Management, and operations to enhance compliance efforts.
• Monitor healthcare industry trends and changes in regulations to ensure ongoing compliance.
• Research Federal and State regulations and guidelines, communicate the requirements to various departments, and assess the organization's compliance with the requirements.
• Conduct or assist in external and internal audits and reviews.
• Track findings and corrective actions.
• Analyze data from audits to identify patterns, trends, and variances and compile statistical analysis.
• Serve as the primary RAC and appeals liaison for the hospital, including preparation of quarterly statistical summaries on all government claim recovery activities and present trends/findings to the Compliance Committee.
• Coordinate and maintain appropriate workflow with the Appeals team, tracking all CMS audits such as RAC, ADR, CERT.
• Conduct or assist in internal compliance investigations and reviews.
• Maintain current working knowledge of regulatory requirements associated with hospital and professional coding, billing, documentation, and reporting requirements.

Requirements

• Bachelor's Degree in Health Information Management, Nursing, Health Care administration or a compliance-audit related field, or equivalent work experience.
• 3-4 years of experience in a health care environment.
• Understanding of coding.
• Ability to interact effectively with employees, the public, senior executives, and Board of Directors.
• Outstanding interpersonal, verbal and written communication and presentation skills.
• Proficiency with technology and ability to learn new applications.
• Demonstrated ability to think critically, use analytical skills, and make logical decisions.

Nice-to-haves

• Experience performing coding, documentation and billing audits.

Benefits

• Full-Time Employee Status
• Salary Range: $66,000 - $105,000 Annually