Director of Internal Audits
2 days ago
Melville
Job DescriptionOur client is seeking to add a Director of Internal Audits to their team.& JOB SUMMARY Strategic oversight of the internal audit function across the organization ensuring risk-based audit coverage and providing independent and objective assessment of the organization’s governance, risk management, and internal control systems. Responsible for planning, executing, and reporting on operational and regulatory compliance-related audits and reviews. Ownership of the Internal Audit Workplan. ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITES • 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, • 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., • Related experience preferred., • 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, • Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions., • The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job., • The work requires the following activities: climbing, bending, stooping, kneeling, reaching, sitting, standing, walking, lifting, finger dexterity, grasping, repetitive motions, talking, hearing and visual acuity. The work is performed primarily indoors., • The employee must occasionally lift and/or move up to 25 pounds.