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Compliance Auditor Analyst, Medicare

Posted on Oct 29, 2020 by Integra MLTC

North New Hyde Park, NY
Admin & Secretarial
Immediate Start
Annual Salary

Job Description


The Compliance Auditor/Analyst, Medicare will assist the Director, Medicare Compliance with supporting the Medicare compliance program operations, performing detailed compliance audits focused on the Medicare line of business, assisting on the analysis of compliance program effectiveness, and supporting additional key compliance initiatives, and compliance projects.


* Plans, coordinates and conducts compliance audits in accordance with the approved Medicare audit plan, including internal audits and vendor audits
* Ensures compliance with regulations and controls by examining and analyzing records, reports, operating practices, and documentation; identifies compliance risks and recommends opportunities to strengthen the internal control structure
* Completes audit work papers and creates reports to document audit findings
* Maintains excellent documentation of all audits, methodologies employed, results, implementation of recommendations, and monitoring
* Communicates audit progress and findings by preparing reports, discussions with management and providing information in meetings
* May assist with identifying and resolving deficiencies
* Reviews, disseminates and tracks HPMS memos
* Reviews and submits marketing material to HPMS
* Assists in the development of Compliance policies and procedures with strong working knowledge of policy development
* Maintains a strong working knowledge of state and federal legislation, statutes and regulations, and local, state, and national health issues affecting Medicare Managed Care organizations
* Participates in other compliance program elements for the ongoing demonstration of compliance effectiveness
* Collaborates with the Director, Medicare Compliance on external audits and reviews, which are initiated by government agencies or government-contracted organizations
* Assists Director,Medicare Compliance with responding to CMS requests and audits
* Performs other duties as assigned

Reference: 28146825

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