Compliance Auditor
Compliance Auditor
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1 Vacancy
Job Description
Job Details
ChristianaCare is searching for a Compliance Auditor to support the Office of Compliance & Privacy through assigned compliance activities and audits to ensure effective documentation. Through communication and training activities they provide information or clarification on audit results compliance inquiries documentation standards guidelines and regulatory requirements. They provide operational technical and auditing support for the Office of Compliance & Privacy.
Education and experience requirements:
Bachelors Degree is required.
Equivalent of 5 years experience in nursing compliance auditing clinical chart reviews medical necessity review/auditing revenue integrity and/or compliance department operations/regulations
Certification (at least one of the following are required and are to be maintained as a condition of employment)
Certified in Healthcare Compliance (CHC); Certified in Healthcare Privacy Compliance (CHPC)
In-depth knowledge of compliance and privacy regulations
Must be proficient in CMS Conditions of Participation CMS Conditions of Payment and Inpatient and Outpatient Prospective Payment System. Strong analytical and communication skills.
Candidates who do not hold a CHC will be given consideration but will need to obtain the CHC within 2 years of their hire date with the company.
Experience in compliance and privacy auditing techniques and methods preferred but not required
Principal duties and responsibilities:
Helps the Office of Compliance & Privacy adhere to assigned audit schedule and reviews as outlined in the Departmental Compliance Workplan
Assists with reviewing internal and external inquiries regarding compliance and privacy matters including government and third-party payor requests.
Conducts audits and focused reviews to ensure compliance with government and payor guidelines.
Assists with maintaining regular and consistent governance-level reporting and metrics for the Compliance department including but not limited to dashboards board reporting weekly monthly and annual compliance & ethics reporting.
Reviews documentation to ensure appropriate assignment of facility-based and provider-based clinical documentation and medical necessity
Maintain a working knowledge of HIPAA and CMS regulations.
Participate in the planning and scheduling of compliance projects.
Research compliance related questions upon request from departments and/or practices.
Identify and report potential audit and compliance risks.
Special requirements:
Must maintain current CCB certification
When you become an employee at ChristianaCare you are joining a robust healthcare organization that truly cares about their patients and their caregivers. For the second consecutive year Forbes magazine has ranked ChristianaCare as one of the best large health systems to work for in the United States! Guided by excellence and love our Caregivers enjoy a multitude of employee benefits that include:
Full Medical Dental Vision and other insurance benefits
403 (b) with an employer match
Generous paid time off with annual roll-over and opportunities to cash out
12 week paid parental leave
About Christiana Care:
Headquartered in Wilmington Delaware ChristianaCare is one of the countrys most dynamic health systems centered on improving health outcomes making high-quality care more accessible and lowering health care costs. ChristianaCare includes an extensive network of outpatient services home health care medical aid units two hospitals (1227 beds) a Level I trauma center and a Level III neonatal intensive care unit a comprehensive stroke center and regional centers of excellence in heart and vascular care cancer care and womens health. ChristianaCare is a not-for-profit teaching health system with more than 260 residents and fellows. We are continually ranked by US News & World Report as a Best Hospital. With our unique data-powered care coordination service and a focus on population health and value-based care ChristianaCare is shaping the future of health care.
Post End Date
Jun 9 2025EEO Posting Statement
Christiana Care Health System is an equal opportunity employer firmly committed to prohibiting discrimination whose staff is reflective of its community and considers qualified applicants for open positions without regard to race color sex religion national origin sexual orientation genetic information gender identity or expression age veteran status disability pregnancy citizenship status or any other characteristic protected under applicable federal state or local law.
Employment Type
Full-Time
