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Bozeman Health · 1 month ago

Compliance Auditor (FT- 1.0, Day Shift)

Bozeman, MT

Full-time

Onsite

Mid Level

3+ years exp

Bozeman Health is committed to maintaining an effective compliance program, and they are seeking a Compliance Auditor to support this initiative. The role involves planning and executing risk-based audits, monitoring adherence to regulations, and collaborating with various departments to identify vulnerabilities and recommend corrective actions.

Health CareHospitalMedical

Responsibilities

Develops and maintains a risk‑based annual audit plan aligned with organizational risks and OIG work plan priorities

Conducts audits of clinical documentation, billing, coding, and operational processes to evaluate compliance with applicable laws, regulations, payer rules, and internal policies

Reviews medical and billing records for coding accuracy and medical necessity; validates documentation sufficiency and identifies trends

Monitors adherence to HIPAA privacy and security requirements, including appropriate handling of PHI and breach prevention practices

Investigates reported compliance concerns and hotline allegations; documents findings, determines root causes, and recommends corrective actions

Prepares clear, concise audit reports and dashboards; presents results and risk‑based recommendations to leadership and stakeholders

Tracks and validates completion of corrective action plans (CAPs) to ensure timely and sustained remediation

Supports preparation for and response to regulatory surveys, inquiries, and external audits; coordinates evidence collection and responses

Maintains compliance data repositories, audit workpapers, and tracking systems with accurate, timely documentation

Collaborates with departmental leaders to prioritize work, coordinate information requests, and minimize operational disruption during reviews

Assists in developing and delivering compliance education for leaders, providers, and staff; supports onboarding and orientation activities

Stays current on changes in healthcare regulations and payer policies; communicates impacts and updates procedures accordingly

Qualification

Healthcare complianceAuditingClinical documentation reviewEHR systems (Epic)CMS guidelines knowledgeHIPAA complianceMicrosoft ExcelAnalytical skillsCommunication skillsInterpersonal skills

Required

Bachelor's degree in healthcare administration, business, accounting, or related field

Professional certification (e.g., Certified in Healthcare Compliance (CHC), Certified Professional Compliance Officer (CPCO)); or ability to obtain within twelve (12) months of hire

Three (3) years of experience in healthcare compliance, auditing, or a related field

Intermediate knowledge and experience reviewing clinical documentation, billing, and coding for compliance

Intermediate knowledge and experience with electronic health records (EHR) systems (preferably Epic) and compliance/audit management tools

Intermediate knowledge of CMS guidelines, payer requirements, HIPAA Privacy and Security Rules, and foundational healthcare regulations (e.g., Anti‑Kickback Statute, False Claims Act, EMTALA)

Intermediate proficiency with Microsoft Excel and report preparation; familiarity with statistical sampling methods for audits