Director of Compliance Audit

Our client is one of the top pediatric and academic medical centers in the United States.

A partial list of their honors and awards includes the following:

• U.S. News & World Report Honor Roll
• They were the only hospital in Illinois ranked in all 10 specialties and was one of 11 hospitals nationally to receive the Honor Roll award.
• Magnet Recognized
• Association for the Accreditation of Human Research Protection Programs (AAHRPP)
• Top Hospital' for Patient Safety
• LEED-certified to the Gold Level
• Level 1 Surgery Center
• Parents Magazine Top 10 Hospital
• Health Care's Most Wired 2017

They have engaged our firm to perform a national search to identify the top candidates in the country to help take their Audit and Compliance services to the next level.

The Director of Compliance Audit will report to the Senior Director of Audit (the Senior Director) and will be responsible for the design and implementation of an effective compliance auditing and monitoring program designed to prevent, detect, and respond appropriately to compliance risks, including but not limited to coding and documentation. This role will direct the activities of the Compliance Audit staff, which may include co-sourced audit providers. Compliance Audit is part of the Office of Compliance and Integrity.

Responsibilities:

Assist the Senior Director by conducting periodic assessments of compliance risks and by developing and implementing an annual compliance auditing and monitoring plan. Develop and implement processes for routine compliance-focused audits of hospital and physician claims data. This audit activity will focus on assuring appropriate coding and billing by both providers/clinicians and individual coders where appropriate. Identify and evaluate the potential for data analytics and data mining capabilities to strengthen the ability to identify potential compliance risks in claims processes and to focus the use of compliance resources. Identify and monitor regulatory changes related to compliance risks, particularly coding and billing, and facilitate awareness of these changes to other members of the Office of Compliance and Integrity, as well as to applicable stakeholders throughout the Medical Center. Recruit and maintain a Compliance Audit team skilled in performing audits of compliance risk, focused on hospital and physician coding and billing. Directly oversee the work performed by the Compliance Audit team to ensure efficient and effective work product, that results are well supported and communicated to stakeholders in a timely and collaborative manner. Develop and maintain strong working relationships with management across all hospital operating areas. Assist in development and monitoring of the Compliance Audit budget. Assist with development and delivery of materials/presentations/reports to the Executive Compliance Committee and to the Compliance Oversight Committee of the Board.

Qualifications:

• Must have a bachelor’s degree in Health Information Management, healthcare administration, a clinical field, business administration, or related field.
• Master’s degree or a juris doctorate preferred.
• Must have seven to ten years of relevant and progressively responsible experience as a healthcare compliance professional including at least five years’ experience overseeing audits of coding and documentation.
• Coding certification (RHIA, RHIT, CCS, or CCS-P) is preferred.
• Must have demonstrated knowledge of healthcare compliance risk areas, to include but not limited to Medicare and Medicaid coding and billing requirements.

Our client offers incredible compensation, world class benefits and the opportunity to work with some of the worlds best clinicians in some of the best facilities in the best city in the country!

For prompt and confidential consideration, please send a resume to the link below:

Click here to apply online