Job Functions, Duties, Responsibilities and Position Qualifications:
The Sonic Healthcare USA Billing & Compliance Audit Director will design, develop, and implement a compliance audit function (SHUSA annual compliance audit plan) that includes review of claims and laboratory compliance areas of risk. This function will develop and implement systems, software, policies, and procedures to assist laboratories in meeting audit objectives. This role will track performance metrics and corrective actions and report findings to the Compliance Committee.
The Billing & Compliance Audit Director role is national in scope and will work with affiliated location compliance and billing personnel as well as executive leadership to educate, and drive adoption and adherence to SHUSA annual compliance audit plan.
- Develop audit plan using policy, regulations, laboratory industry regulatory guidance, Department of Health and Human Services, Medicare & Medicaid Services, etc.
- Foster and maintain working partnerships with internal audit, billing department and compliance staff throughout entire organization.
- Perform compliance related functions or projects based on coding, billing, CMS changes.
- Research and provide expert billing advice, prepare and distribute notices on CMS billing, audit, and regulatory updates affecting laboratory industry.
- Coordinate, assist or conduct compliance investigations as required, which may include inspections of company policies and regulatory adherence, as well as inquiries into suspected or reported deviation from compliance program requirements.
- Leads the development of compliance-related dashboards intended to inform and serve as a resource for the organization.
- Prepare written reports of audit findings and recommendations and present to the stakeholders, executives, Compliance Committee and others as needed.
- Evaluates the adequacy of corrective actions to improve deficiencies, maintains audit records.
- Facilitates, develops, and implements special projects as assigned by the Chief Compliance or Legal Officer.
- Bachelor Degree required; Business Administration, Healthcare Related Field, Public Accounting, Finance or related area desired.
- 5 years experience with healthcare regulatory or compliance related duties.
- 3 years management level experience.
- Clinical laboratory experience highly desired.
- Certified coder or experienced compliance professional with extensive experience in healthcare optimal, preferably laboratory.
- Certification (or in process certification) in Healthcare Compliance (CHC) a plus:
- Strong interpersonal skills required.
- Ability to operate effectively in a matrix environment.
- Excellent working knowledge of:
- Healthcare compliance
- Medicare and Medicaid billing regulations
- State privacy Laws
- Stark Law and Anti-Kickback statute
- CMS and public Auditing Standards
Scheduled Weekly Hours:
Sonic Healthcare USA, Inc
Sonic Healthcare USA is an equal opportunity employer that celebrates diversity and is committed to an inclusive workplace for all employees. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, age, national origin, disability, genetics, veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
Web Reference : AJF/317129485-202
Posted Date : Mon, 15 Aug 2022
Please note, to apply for this position you will complete an application form on another website provided by or on behalf of Sonic Healthcare. Any external website and application process is not under the control or responsibility of IT JobServe