Plans, coordinates and executes review processes/activities of the entities of Community Medical Centers (CMC). Works under the general supervision of the Manager and CAECO and follows departmental policies and procedures as well as limited instructions in carrying out daily tasks. Provides audit and risk assessment services. Assists by reviewing the organization’s operations, adequacy of internal controls, compliance with laws and regulations, adherence to policy and procedures, safeguarding of assets, and accuracy of reported financial activities. Supports governance by assuring the organization of the state of the control environment.
The Senior Internal Auditor must be a self-starter, must possess sufficient skills, training and experience in healthcare to work independently. Must have proficient level computer knowledge (including but not limited to; All Microsoft Applications, report writing applications and other audit tools. Must have high collaborative, communication and writing skills. Knowledge of Medicare, third-party requirements, CDM, revenue codes assignments, CPT, HCPCS, ICD-9, ICD-10, DRG and APC classification systems; medical terminology; billing and reimbursement processes and EHR. Must perform duties honestly, confidentially and objectively. Must possess a deep understanding of healthcare and the laws that regulate its delivery.
EXPERIENCE AND EDUCATION:
MINIMUM REQUIRED: Bachelor's degree in Accounting, Finance, Information Systems/Computer Science or healthcare related field. Five years' experience assessing risk and performing audits (financial, operational, IT and/or compliance) in a healthcare environment. Experience or additional course work in charge master, documentation, coding and billing for hospitals, accounting, auditing, system analysis, programming or computer operations management.
PREFERRED: Experience with the following applications: EPIC, Electronic Medical Records (EMR), Lawson and Data Analytics and Continuous Monitoring Software Solutions (ACL).
MINIMUM REQUIRED: N/A
PREFERRED: Certified Public Accountant (CPA), Certified Internal Auditor (CIA), Certified Information Systems Auditor (CISA) and/or ACL Certified Data Analyst (ACDA).