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LifeBridge Health · 2 hours ago

Institutional Compliance Auditor

Westminster, MD

Full-time

Onsite

Entry, Mid Level

$70K/yr - $88K/yr

1+ years exp

LifeBridge Health is a dynamic, purpose-driven health system redefining care delivery across the mid-Atlantic and beyond. The Compliance Auditor supports the LifeBridge Health Compliance Program by conducting compliance audits and education to ensure adherence to various laws and regulations.

AssociationFitnessHealth CareNon Profit

Responsibilities

Conducts outpatient and inpatient hospital, post-acute care (DME, Home Care, etc.), and other facility or specific program audits as assigned

Analyzes audit findings and determines if auditee is compliant with applicable laws, regulations, and/or documentation/coding/billing requirements or other requirements

Prepares draft reports in accordance with Institutional Compliance work standards

Participates in exit meetings with auditees

Researches, compiles, analyzes, and drafts audit topic specific information in preparation for completing assigned audits

Researches audit topic to determine applicable requirements and regulations, obtains internal information necessary for audit, and develops draft audit tool(s)

Contributes to the audit plan (scope, time period for review, sample and sample size, etc.) and analyzes audit data file(s) for accuracy of inclusion of requested data elements and identifies any trends/patterns

Develops and conducts compliance education as assigned, for clinicians, leadership, employees, and others

Reviews, researches, and compiles local, state, and federal regulatory information; coding, billing, and documentation requirements; and other related information

Analyzes regulatory and other pertinent information and drafts a summary of requirements

Conducts education in relation to audits, compliance inquiries, institutional policies and requirements related to laws, regulations, etc

Researches and responds to compliance inquiries. Reviews, researches, and responds to regulatory, billing, coding, documentation, and other inquiries from providers, leadership, employees, and others within the LifeBridge Health System

Supports the Compliance Officer/Compliance Leadership with the investigation of any issues of potential non-compliance

Completes all assigned investigational tasks timely

Conducts research related to the topic under investigation

Conducts audits as part of an investigation to determine compliance with coding, billing, and documentation regulations/guidelines

Continuously seeks opportunities to build internal and external relationships and maintain industry knowledge to perform all assigned tasks

Maintains basic knowledge of Local, State and Federal laws and regulations, the Centers for Medicare and Medicaid Services’ (CMS) conditions of participation and payment for hospitals, and Long-Term Care regulations