Talentsearchpro · 1 day ago
Director of Internal Audits (healthcare internal auditing background)
Melville_NY
Full-time
Onsite
Lead/Staff, Director/Executive
5+ years expTalentsearchpro is seeking a Director of Internal Audits to provide strategic oversight of the internal audit function across the organization. This role involves planning, executing, and reporting on operational and regulatory compliance related audits, while ensuring adherence to governance, risk management, and internal control systems.
Human Resources
Responsibilities
Oversees and ensures audit work is performed and documented in accordance with departmental standards
Owns the responsibility of Internal Audit Work Plan-this plan will include all specificities such as audit description, frequency, and audit sampling
Plan audits that Office of Inspector General and the Office of the Medicaid Inspector General will be reviewing as part of their workplan and ensure the Company is compliant
Assigns and ensures implementation of the work plan and benchmarks progress
Acts as primary liaison between the department’s employees, appropriate Vice Presidents and division heads
Works with the Compliance Officers to collaborate and own audits that are on the Compliance Work Plans
Ensures audits are being conducted on medical record documentation to identify under coded and up coded services; reviews report findings and sends to the physicians to provide awareness/education on accurate coding practices and compliance issues
Prepares timely audit reports for Executive Management, Compliance Officers and the Chief Financial Officer
Meet deadlines of assignments, multitask multiple demands and work with all types of individuals up to and including the Chief Financial Officer
Research, analyzes, and responds to inquiries regarding compliance, inappropriate coding, denials and billable services
Interacts with physicians, business offices, provider enrollment, managed care, informatics and other departments regarding timely and accurate billing, and documentation, policies and procedures and regulations; obtains clarification of non-specific documentation
Acts as a team player, collaborating and supporting colleagues and peers across the organization, while still capable of working independently when needed
Attends conferences, workshops and in-house sessions to receive updated coding information and changes in coding and/or regulations
Designs audit plans and annual work plans
Assesses with other departments regarding risk assessments and corrective actions
Cultivate relationships across departments to promote ethical practices, transparency, and continuous improvement
Lead, mentor, and develop internal audit staff; foster a culture of accountability, learning, and professional development
Promote a continuous improvement mindset and help build audit capacity across the organization
Performs other incidental and related duties as required and assigned
Qualification
Required
High school diploma or GED required
Bachelor's degree in Business Administration, Health Care Administration or related appropriate field required
5 to 7 years' minimum experience in auditing, preferably within a healthcare organization
10 years' experience minimum in a supervisor position
Ability to direct, manage and supervise employees
Knowledge of CPT codes and ICD-9/10 codes
Knowledge of CMS Guidelines
Knowledge of Federal and State Compliance regulations
Knowledge of anatomy and medical terminology
Ability to conduct interviews and gather information
Knowledge of analytical ability
Ability to maintain confidentiality while multitasking
Excellent organizational skills and the ability to balance multiple tasks and priorities while focusing on the details
Strong interpersonal, verbal and written skills required
Ability to function well in a high-paced and at times stressful environment
Excellent time management skills with a proven ability to meet deadlines
Demonstrates strong communication, written, and typing skills
Proficient with Microsoft Office or related software
Ability to work efficiently both independently and in a team environment
Strong project management and team leadership capabilities
Exceptional organizational skills and detail oriented
Preferred
Related experience preferred
Company
Talentsearchpro
Talent Search Pro, we understand that making the right hire is a critical action that you have to take as an organization.
2-10 employees
Funding
Current Stage
Early StageCompany data provided by crunchbase