Compliance Auditor

Compliance Auditor

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Title: Compliance Auditor

Are you an experienced Compliance Auditor looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions – this is the position for you!

• As the Compliance Auditor, you would be responsible for monitoring and auditing both Medicare and Medicaid products to ensure both internal and external performance and regulatory requirements are in compliance.
  

Advantages of this Opportunity:

• Competitive salary, negotiable based on experience
  
• Benefits offered, Medical, Dental, and Vision
• Fun and positive work environment
• Weekly deposit options

More Insight of Daily Responsibilities:

• Collaborates with Care Management leadership on developing audit tools and audit project plans
• Ensures audit and monitoring timelines are met
• Provides support to the communications process which includes provider and member adverse notifications
• Provides support for the adverse determination process which includes ensuring notification meets regulatory/contractual requirements for content and timeliness
• Produces adverse determination information in support of an audit
• Assists management in developing project plans to ensure ongoing monitoring and oversight of utilization management functions
• Assists management with the collection of data and performs audits of utilization management functional areas

Qualifications

What We Look For:

• A High School or GED with qualified healthcare employment experience Required
  
• An Associate's Degree in a related field Preferred
• 3+ years of experience in health care communication or compliance related duties

Additional Information