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Behavioral Health Group - BHG · 5 hours ago

Compliance Audit Manager

United States

Full-time

Remote

Mid, Senior Level

5+ years exp

Behavioral Health Group - BHG is seeking a Compliance Audit Manager to contribute to the development of an auditing and monitoring program. The role involves planning and completing compliance audits, managing compliance auditors, and ensuring adherence to regulatory standards.

Addiction TreatmentHealth CareInsuranceOutpatient CarePayments

Responsibilities

Design, perform and manage all aspects of compliance audits including plans to help assess risk and compliance across all areas of the organization and offer recommendations to mitigate company risk and exposure

Identify and evaluate risk and assess systems of controls

Lead and manage Compliance Auditors; Provide initial and on-going training for Compliance Auditors and other team members as applicable; and, review internal audits and provide feedback to Compliance Auditors

Participate as a member of the organization’s internal compliance committee

Prepare and deliver executive summary memos and presentations to board, management, committees, or other stakeholders

Identify, prepare, report, and manage audit findings and observations, including monitoring progress of action plans, while ensuring consistency of work papers, memos, internal audit reports, agendas and all other work products and assignments

Manage the annual project plan through scheduling and meeting deadlines

Demonstrate a high-level understanding of coding guidelines in the areas of Evaluation and Management, Mental Health, Substance Abuse, Lab, and others as applicable

Maintain current knowledge of coding guidelines, laws, rules, policies, and regulations applicable to the organization’s operations

Coordinate and assist with the annual organizational risk assessment and work plan development and execution

Monitor compliance with documentation guidelines and billing practices

Serve as a subject matter expert for the development and implementation of policies related to coding and supports all team members to ensure compliance with organizational policies related to area of expertise and support all team members to ensure compliance with organizational policies and procedures related to area of expertise

Ensure compliance with all federal and state regulatory bodies, as well as accrediting agencies and assist with preparation of responses to regulatory inquiries

Assist with reviewing all reports related to billing and coding non-compliance and collaborate with appropriate compliance team members and other organizational stakeholders on subsequent investigations

Qualification

Healthcare compliance auditingCertified Professional Coder (CPC)Certified in Healthcare Compliance (CHC)CMSOIGDOJ guidelinesHIPAA Privacy Law experienceRegulatoryAccrediting bodies experienceMicrosoft Office Suite proficiencyVerbal communicationWritten communicationInterpersonal skillsOrganizational skills

Required

Bachelor's degree in healthcare field or equivalent experience

Certified Professional Coder (CPC) or equivalent certification required

Minimum five (5) years of previous healthcare compliance and auditing experience required

Minimum one (1) year of previous supervisory or management experience required

Knowledge and experience related to CMS, OIG, and DOJ guidelines

HIPAA Privacy Law and 42 CFR Part 2 Rules experience required

Experience in working with regulatory and accrediting bodies

Excellent verbal and written communication skills

Excellent interpersonal skills

Strong organizational skills with superior attention to detail

Proficient with Microsoft Office Suite

Preferred

Certified in Healthcare Compliance (CHC) or equivalent certification preferred

One (1) year experience in a mental health and/or substance use setting preferred

Company

Behavioral Health Group - BHG

Behavioral Health Group (BHG) is the largest network of Joint Commission-accredited outpatient opioid treatment and recovery centers in the U.S., delivering comprehensive, personalized evidence-based medical and behavioral therapies for individuals with opioid use disorder.

Founded in 2006

Dallas, Texas, USA

1001-5000 employees