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Community Health Network · 4 weeks ago

Lead Internal Auditor - Compliance (RN)

Indianapolis, IN

Full-time

Hybrid

Senior Level, Lead/Staff

5+ years exp

Community Health Network is a healthcare organization dedicated to providing exceptional care to its neighbors. The Lead Internal Auditor (Compliance, RN) will review healthcare functions, focusing on compliance with coding, billing, and medical record documentation while leading audit efforts and guiding less experienced auditors.

CommunitiesHealth CareHospital

Responsibilities

Determining audit scope

Developing audit plans

Evaluating audit evidence

Drawing conclusions based on billing and federal/state regulations

Providing guidance or expertise to less experienced auditors on clinical/compliance issues

Drafting audit reports to effectively communicate scope, work performed, results, and proposed action plans

Qualification

Healthcare auditingCoding/billing systemsCertified Internal AuditorBachelor of Science in NursingAnalytical skillsEffective communicationProject managementTeam collaboration

Required

Bachelor of Science in Nursing (BSN) is required

In lieu of degree, a combination of education and experience will be considered

Minimum of five (5) years in healthcare auditing and/or internal control documentation and evaluation

Minimum of three (3) years as a Registered Nurse

Knowledge of coding/billing systems utilized in healthcare (CPT, HCPCS, ICD-10) and documentation/regulatory requirements for billing healthcare services

Effective written and verbal communication skills

Strong planning, analytical, organizational, and business skills

Knowledge of healthcare systems, including coding and reimbursement expertise

Project management expertise

Perform audits to evaluate adequacy and effectiveness of internal controls

Recommend improvements to ensure compliance and financial integrity

Develop and refine audit programs; execute audit tests and interpret results

Draft clear, persuasive reports of findings and recommendations, present to leadership

Lead, direct, and supervise other auditors; serve as a resource for team members

Ability to work independently and collaboratively as part of a team