Senior Compliance Auditor – RN

This is a fully remote position, open to applicants in Ohio, +1 more state.

📋 Description

• Engage in thorough or stratified audits pertaining to skilled home health, hospice, palliative care, personal care services, and behavioral health.

• Evaluate billing compliance trends and provide educational support to agency leaders.

• Offer constructive recommendations and positive insights to the Billing Compliance Audit team.

• Compile written audit results for agency leaders following the finalization of audit findings.

• Conduct secondary reviews and oversee the development, revisions, and assessments of PCS policies.

• Contribute to compliance and quality education, along with updates to compliance resource manuals, policies, procedures, and tools.

• Examine audits for precision and ensure auditors are well-versed in billing regulations.

• Track audit deficiencies and create extensive remediation training.

• Collaborate with clinicians, managers, account executives, intake coordinators, directors, and administrative personnel on regulatory compliance.

• Provide guidance to clinicians and Clinical Managers on coding, documentation, OASIS guidelines, and CMS inquiries.

• Work alongside the Compliance Department across various compliance functions.

• Uphold patient and staff privacy and confidentiality in accordance with HIPAA regulations.

• Stay informed on payment regulations, federal and state laws, and accreditation standards.

• Report serious compliance, billing, and business risks to compliance and functional leadership.

• Assist in ensuring that audit programs focus on prevention, timely reporting, and remediation.

• Collaborate with operational leaders on compliance initiatives and risk-based action plans.

• Participate in audit findings discussions and support the development and timely execution of corrective action plans.

⛳️ Requirements

• Associate or Bachelor of Science in Nursing.

• A minimum of five (5) years of experience in Corporate Compliance healthcare coding/billing audits.

• At least two (2) years of proven leadership experience.

• Certified Homecare Coding Specialist (HCS-D), Certified OASIS Specialist-Clinical (COS-C), or a commitment to obtain certification within one (1) year.

• Registered Nurse with experience in home health and hospice coding.

• Compliance with all applicable agency policies and procedures regarding health screening and required testing.

• Minimal travel is required.

🏝️ Benefits

• Competitive compensation package.

• Tuition reimbursement for full-time staff.

• Free continuing education opportunities for all employees.

• Advancement opportunities.

• Comprehensive medical, dental, and vision insurance plans.

• 401(K) plan with employer match.

• Paid time off.

• Paid holidays.

• Family bereavement leave.

• Pet bereavement leave.

• Pet insurance.