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Geisinger · 1 month ago

Director of Compliance Audits - Healthcare Legal and Regulatory (Eastern United States resident)

United States

Full-time

Remote

Director/Executive

8+ years exp

Geisinger is a healthcare organization focused on patient care and community wellbeing. The Director of Compliance Audits ensures the integrity and accuracy of billing practices, overseeing audit activities to ensure compliance with federal guidelines and regulations, while managing a team of auditors and conducting risk analysis.

Health CareHospitalMedical

Responsibilities

Manages, plans, organizes, and ensures the completion of compliance audit activities in accordance with the Compliance Work Plan

Provides oversight of audits, including audit scope, objectives, and final reports

Coordinates the development and implementation of all corrective action and improvement plans with critical attention to performing a root cause analysis

Works in collaboration with the Revenue Management Compliance AVP to develop and implement strategic goals for the audit team

Directly supervises Revenue Management Compliance audit staff, including supervisors and auditors for hospital and professional auditing

Prepares responses to governmental audits, evaluate findings, and manage the appeals process

Manages audits conducted by vendors and payers, providing status reports to senior leadership

Provides guidance and serve as an institutional resource for Geisinger leadership, management and medical staff regarding federal payer laws and regulations impacting billing compliance

Mentors and coaches audit staff, facilitate audit staff training opportunities and support career growth. Work with management team members and Human Resources to ensure performance issues are addressed

Proactively communicates relevant information such as issues, problems and successes within the compliance realm to Revenue Management Compliance AVP

Qualification

Compliance Audit ProgramCoding CertificationRisk AnalysisManagerial ExperienceFederal Guidelines ComplianceTeam ManagementCommunication SkillsMentoring Skills

Required

One of the following coding or auditing certifications are required (CCS, CPC, RHIA, RHIT or CPMA)

Bachelor's Degree-Related Field of Study

Minimum of 8 years-Related work experience

Minimum of 5 years-Managerial/Supervisory

Preferred

Master's Degree-Related Field of Study

Benefits

We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners.

Company

Geisinger

Glassdoor3.5

Geisinger is a health and wellness organization that offers orthopaedic, weight-management, and heart care services. It is a sub-organization of Risant Health.

Founded in 1915

Danville, Pennsylvania, USA

10001+ employees