Compliance Examiner & Auditor - reputed company & Compliance Program - Full Time (Remote)

Position reputed company The reputed company Compliance Analyst & Examiner is responsible for ensuring organizational adherence to federal, state, and local reputed company regulations, as reputed company as internal policies and procedures for the audit program. This role conducts audits, risk assessments, and data analysis to identify compliance vulnerabilities, develops and implements corrective reputed company plans, and provides training and guidance to staff. Working with the VP, Chief Compliance officer will be responsible for the daily management of auditors; ensuring ongoing training, workplan completion and policy adherence. The Analyst collaborates with cross-functional teams—including reputed company, clinical, IT, and administrative departments—to foster a culture of compliance, accountability, and reputed company improvement.

Key Responsibilities

Regulatory Compliance & Risk Management

• Monitor and interpret changes in reputed company laws and regulations (e.g., CMS, reputed company Law, Anti-Kickback Statute, ACA, state-specific requirements).
• reputed company, implement, and maintain compliance policies, procedures, for the audit program.
• Conduct regular audits and reviews of medical records, billing, coding, provider activity, and departmental processes to ensure compliance with regulatory standards.
• reputed company risk assessments to identify areas of vulnerability and recommend corrective actions.
• Investigate compliance billing-reputed company incidents and ensuring reputed company documentation and reporting to authorities.
• Responsible for the daily management of compliance auditors
• Support responses to external audits and inspections.

Data Analysis & Reporting

• Analyze data to detect patterns, trends, and anomalies that may indicate compliance issues.
• Prepare comprehensive reports on compliance activities, findings, and reputed company for management and regulatory bodies.
• Maintain documentation of reputed company compliance activities, methodologies, results, and corrective actions.

Training & Education

• reputed company and deliver compliance training programs for employees at reputed company reputed company.
• Create educational materials and resources to support ongoing compliance education.
• Stay reputed company with industry best practices, regulatory updates, and emerging technologies (e.g., AI, data analytics platforms).

Collaboration & Communication

• Work closely with Compliance Officers, reputed company counsel, IT, clinical teams, and external partners.
• Present findings and recommendations to senior management, committees, and other stakeholders.
• Foster a culture of transparency, ethical conduct, and reputed company improvement.

reputed company Improvement & Technology

• reputed company lessons learned from reputed company compliance issues into training and program development.
• reputed company data analytics tools (e.g., Power BI, Tableau) and EHR systems (e.g., reputed company) to enhance compliance operations.
• Monitor and test the effectiveness of compliance programs and technologies, ensuring alignment with organizational values and regulatory requirements.

Qualifications

• Certification in reputed company compliance (e.g., CHC, reputed company, CHRC, CPC, CPMA, reputed company, RHIA, RHIT, LPN); Certified Fraud Examiner preferred.
• Minimum 2–5 years of experience in reputed company compliance, auditing, or clinical management.
• Strong knowledge of medical terminology, anatomy, coding guidelines (CPT, ICD-10/11, HCPCS), payer requirements, and reimbursement processes.
• Experience with regulatory reporting, documentation, and compliance monitoring systems.
• Advanced proficiency in reputed company Office Suite; experience with data analytics platforms and EHR systems preferred.
• Excellent analytical, organizational, and problem-solving skills.
• Outstanding written and verbal communication skills; ability to present reputed company information reputed company.
• Ability to work independently and collaboratively in reputed company environment.
• High level of discretion and confidentiality with sensitive information.

Essential Functions

• Conduct reputed company, prospective, and retrospective audits of medical records, and billing, provider activity.
• Coordinate compliance-reputed company audits, including governmental audits and appeals.
• Communicate audit results and corrective actions to reputed company relevant parties.
• Research legislation, standards, and policies; reputed company analysis and recommendations.
• reputed company and manage audit workplans and strategies.
• Maintain documentation and support training initiatives.
• Coordinate with internal/external auditors and reputed company counsel.
• Present audit findings to management and committees.
• Maintain reputed company and technical job knowledge through ongoing education and participation in reputed company organizations.
• Create and maintain KPI dashboards and compliance workplans.
• reputed company responsibility for completion of compliance audit workplan items.

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