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Compliance Auditor - Hospital Services

Job Details

Location:
12801 Westlinks Drive, Fort Myers, FL 33913

Category:
Professional

Type:
Full Time

Schedule:
Days

Job Ref:
94103

Location:Westlinks -12801 Westlinks DriveFort Myers FL 33913

Department: Compliance

Work Type: Full Time

Shift: Shift 1/8:00:00AM to 4:30:00PM

Minimum to Midpoint Pay Rate:$33.37 - $45.05 / hour

Summary

The Compliance Auditor will assist in the overall compliance audit and investigative activities to ensure organizational compliance with applicable laws, regulations, and standards of conduct. This person will conduct planned audits, probe audits, chart reviews and contribute to the annual Compliance risk assessment. The Compliance Auditor will also verify reimbursement and/or coding when appropriate. The Compliance Auditor will help complete compliance work plans and provide staff education and internal guidance to operational departments. This person also will investigate compliance and ethical concerns, such as reports of fraud, waste, and abuse.

Requirements

Educational Requirements

Degree/Diploma ObtainedProgram of StudyRequired/
Preferred
and/orAssociatesNursingRequiredorBachelorNursingPreferredand

Additional Requirements



Experience Requirements

Minimum Years RequiredArea of ExperienceRequired/
Preferred
and/or5 YearsClinicalRequired

Additional Requirements

Five years of clinical experience and knowledge of health system operations. Prior regulatory compliance or audit experience preferred.


State of Florida Licensure Requirements

LicensesRequired/
Preferred
and/orRegistered Nurse LicenseRequired

Certifications/Registration Requirements

Certificates/RegistrationsRequired/
Preferred
and/or

Additional Requirements

Coding Certification (CCA, CCS, CCS-P, CPC,or CPC-H) required within one (1) year of hire. Compliance certification (CHC) required within two (2) years of hire.

Other Requirements

Strong research skills and knowledge of clinical quality concepts, medical necessity, clinical documentation, and medical terminology. Knowledgeable in compliance-oriented tasks including reviewing coverage determinations, Medicare materials, final rules, regulations, and organizational policies, preferred. Ability to handle multiple tasks and demonstrate good communication skills preferred. Proficient in the use of Microsoft Office programs and ProDiver reporting application preferred.

US:FL:Fort Myers

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Lee Health
is located in
Fort Myers/
Cape Coral,
Florida
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