The Internal Auditor - Compliance will oversee the internal and external compliance audits for the Mohawk Valley Health System (“MVHS”) audit and compliance function under the guidance and direction of the Chief Compliance Officer. This position will play a key role in assessing and improving the effectiveness of the compliance program across the organization. The Internal Auditor - Compliance will identify areas to be audited based on regulatory guidelines and the company’s risk areas. Plan, execute and report on compliance audits across various functions and departments within the MVHS.
Review and analyze processes and policies to ensure they are aligned with regulatory requirements and internal standards.
Identify potential areas of compliance risk and assess their impact on the organization.
Develop and implement risk assessment strategies to mitigate identified risks.
Assist in the development, communication and enforcement of policies and procedures system wide.
Develop and deliver compliance training based on identified audit findings.
Prepare detailed audit reports and presentations, outlining findings, recommendations and compliance status in collaboration with the Chief Compliance Officer.
Work closely with internal teams, including Legal, Risk Management, and operations to enhance compliance efforts.
Conduct or assist in external and internal audits and reviews. Analyze data from audits to identify patterns, trends and variances and compile statistical analysis.
Serves as the primary RAC and appeals liaison for the hospital, including preparation of quarterly statistical summaries on all government claim recovery activities and presents trends/findings to the Compliance Committee.
Coordinates and maintains appropriate workflow with the Appeals team, tracking all CMS audits such as RAC, ADR, CERT.
Maintain current working knowledge of regulatory requirements associated with hospital and professional coding, billing, documentation and reporting requirements.
Bachelor’s Degree in Health Information Management, Nursing, Health Care administration or a compliance-audit related field, or equivalent work experience.
~Must possess understanding of coding.
~ Ability to interact effectively with employees, the public, senior executives and Board of Directors.
~ Proficiency with technology and able to learn new applications.
~ Experience performing coding, documentation and billing audits.
RHIA, RHIT or CCS or eligible for exam with experience coding acute care inpatient and outpatient records.
Qualified applicants will receive consideration for employment without regard to their age, race, religion, national origin, ethnicity, age, gender (including pregnancy, childbirth, et al), sexual orientation, gender identity or expression, protected veteran status, or disability.
Department LEGAL AND COMPLIANCE
Shift Days
Shift Hours Worked 8.Employee Status A1 - Full-Time
Union Non-Union
