Lead Internal Auditor - Compliance (RN)

Lead Internal Auditor - Compliance (RN)

Community Health Network was created by our neighbors, for our neighbors. Over 60 years later, "community" is still the heart of our organization. It means providing our neighbors with the best care possible, backed by state-of-the-art technology. It means getting involved in the communities we serve through volunteer opportunities and benefits initiatives. It means ensuring our dedicated caregivers can learn and grow to stay at the top of their fields and to better serve our patients. And above all, it means exceptional care, simply delivered and we couldn't do it without you.

The Lead Internal Auditor (Compliance, RN) works under the general supervision of the Manager of Internal Audit, Physician Coding and Compliance and assists in reviewing various healthcare functions, with particular emphasis on compliance with coding, billing, and medical record documentation requirements for hospitals, physician practices, home health, long-term care, surgery centers, and more.

Responsibilities include determining audit scope, developing audit plans, evaluating audit evidence, and drawing conclusions based on billing and federal/state regulations. This individual may also provide guidance or expertise to less experienced auditors on clinical/compliance issues and will draft audit reports to effectively communicate scope, work performed, results, and proposed action plans.

Applicants for this position should be able to collaborate with others in a team setting, have excellent communication skills, and a positive attitude toward problem-solving.

• 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.

• Certified Internal Auditor (CIA) or Certified Coding Specialist (CCS) certification preferred.

• This position will allow flexibility to work remotely. Community caregivers performing work remotely are permitted to live in the following states: Indiana, Illinois, Ohio, Michigan, Kentucky, Florida and Texas. Caregivers are not allowed to perform work remotely outside of the above states. Applicants from other states may apply; however, if hired, they will be required to relocate to one of the above states within 60 days of their employment date.

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.

At Community Health Network, we build teams that deliver exceptional care through empathy, communication and collaboration. We consider ALL an integral part of the exceptional patient experience. We PRIIDE ourselves on not having employees but Caregivers. Join our Community as we make a difference in your community.

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