As the leader of rehabilitative care, Encompass Health offers both facility-based and home-based patient care through its national network of rehabilitation hospitals, home health agencies, and hospice agencies that spans 42 states and Puerto Rico. Setting the standard for providing excellent care, Encompass Health has earned its place among Modern Healthcare’s “Best Places to Work in Healthcare” and the Fortune “World’s Most Admired Companies” for 2021.
The Senior Compliance Auditor conducts clinically-related audits and investigations of a general compliance nature as a part of the Company’s Ethics & Compliance audit a program. The Senior Compliance Auditor executes audit procedures to assess compliance-related controls to safeguard company resources and ensures the effectiveness and efficiency of operations. The Senior Compliance Auditor, in conjunction with the Ethics & Compliance Audit Director and other Compliance Auditors, makes recommendations for improvement of controls and processes to ensure risk management, control and governance systems are functioning as intended and will enable the Company’s objectives and goals to be met.
Responsibilities & Tasks:
- Participates in preparing audit programs based upon the defined objectives. Executes audit procedures. Documents procedures performed and results obtained in accordance with Ethics & Compliance Audit work paper standards.
- Develops compliance audit programs; manages and conducts medical record reviews and regulatory compliance audits and follow-up reviews designed to promote compliance with applicable laws, regulations and related Company policies.
- Identifies and prioritizes potential exceptions, exposures and opportunities for management review. Works with management and staff to obtain concurrence on issues and recommendations.
- Performs quality check of staff and clinical auditors’ work to validate accuracy of results.
- Understands the role of key performance indicators as they relate to areas under audit.
- Implements and ensures audit work conforms to Standards for the Professional Practice of Internal Auditing and other professional coding standards.
- Bases audit findings on systematic analysis of pertinent information and the effect of the decision on all areas of the Company.
- Uses facts and data to completely understand the situation and negotiates resolutions that are acceptable to all involved parties.
- Participates in the follow-up process to ensure resolution of audit findings.
- Interprets the relative significance of issues needing resolution and escalates at appropriate time.
- Efficiently plans, manages and audits to minimize resources in audited departments.
- Works in collaboration with the Ethics & Compliance Audit team to develop annual regulatory compliance audit plan, compliance audit programs, procedures and standards; formulate audit programs to test current procedures in place; prepare work papers to document audit tests performed.
- Audits medical records and billing practices to monitor compliance with applicable regulations and prepares audits, studies and other findings for the Ethics & Compliance Audit Department.
- Utilizes appropriate resources to effectively and successfully execute the responsibilities of the position.
- Under the direction of the Ethics & Compliance Audit Director, conducts compliance investigations, as needed, in accordance with the Encompass Health Investigations Protocol.
License or Certification:
- RN licensure required. Certification in health care compliance (CHC) a plus.
- A minimum of 5 years experience with post-acute or acute care preferred.
- Bachelor’s degree in nursing required. Master’s degree in nursing a plus.
- Knowledge of healthcare regulations and clinical terminology is required.
- General knowledge of federal healthcare programs and compliance issues in the health care environment.
- Working knowledge of auditing techniques and auditing standards.
- Strong PC literacy (Microsoft Word and Excel, email).
Machines, Equipment Used:
- General office equipment such as computer/laptop, telephone, copy/fax machine, calculator, scanner, etc.
- Microsoft Office software, to include Outlook, Word, and Excel.
- Visual acuity, speech recognition, speech clarity.
- Ability to lift, lower, push, pull, and retrieve objects weighing a minimum of 30 pounds. Reasonable assistance may be requested when lifting, pushing, and/or pulling exceeds these minimum requirements.
Skills and Abilities:
- Ability to speak, read, write, and communicate effectively.
- Ability to coordinate, analyze, observe, make decisions, and meet deadlines in a detail-oriented manner.
- Ability to work independently without continuous supervision.
- Indoor, temperature controlled, smoke-free environment.
- Handicapped accessible.
- May work under stressful circumstances at times.
Proficiency or Productivity Standards:
- Has regular, reliable, and predictable attendance and punctuality.
- Adheres to dress code including wearing ID badge.
- Adheres to Standards of Business Conduct.
- May be required to work weekdays and/or weekends, evenings and/or night shifts if needed to meet deadlines.
- May be required to work on religious and/or legal holidays on scheduled days/shifts.
- May be required to perform other duties as assigned by supervisor.
- This position will support cultural diversity by promoting and maintaining an inclusive work environment and culture that is respectful and accepting of diversity.
Shift: Day Job
Job ID: 2126185