SummaryThe Compliance Auditor will report to the Senior Director of Compliance and Privacy and will assist the Manager with developing and implementing compliance auditing and monitoring activities and providing training at LHC Group, Inc. (LHC) to ensure business areas have processes or policies in place to comply with applicable State and Federal laws and regulations related to Medicare and Medicaid rules and regulations, as described by the annual compliance work plan developed by the Chief Compliance Officer (CCO). The clinical and business areas will include, but are not limited to: eligibility, billing, coding, clinical documentation and referrals. Independent monitoring includes analyzing risk assessments, performing audits, creating reports, educating and following up with agencies to ensure processes exist that demonstrate compliance with applicable State and Federal laws, regulations, policies and procedures. The Compliance Auditor will coordinate internal audits, analyses, reviews and investigations of home health, hospice and/or LTAC locations and provide recommendations to improve compliance and internal controls with applicable State and Federal laws and regulations related to Medicare and Medicaid.
Responsibilities- Performs audits of all services line locations, identifying and researching issues and making recommendations to improve compliance policies or procedures and related processes, and monitoring of compliance activities so the providers are in compliance with all legal requirements, policies and procedures and with any other risk areas identified by the CCO (collectively, the Compliance Risk Areas).
- Collaborates with LHC employees to determine risk assessments and audits being performed in the field relating to the Compliance Risk Areas and how to integrate those assessments/audits into the overall risk mitigation plan for LHC's Corporate Compliance Program.
- Creates reports based on audit results, OIG workplans, Red Flag data and other areas/reports as requested.
- Communicates and educates on the audit findings and recommendations, ensuring recommendations are implemented by working cooperatively with the appropriate personnel.
- Conducts Corporate Compliance Program education and training related to policies and procedures, regulations, or legislation that impact operations, by participating in conference calls, webex’s, and on-site meetings/trainings as assigned or requested.
- May be asked by manager to travel to home health, hospice and/or LTAC locations to perform random compliance check visits or compliance audits.
- Assists with coordinating and communicating compliance activities, as well as planning, implementing, and monitoring the Corporate Compliance Program.
- Assists manager and team in planning/organizing audit plans and post audit assessments.
- Stays abreast of external developments in compliance, including government investigations and industry best practices. Maintains a working knowledge of Federal and State laws, regulations and policies applicable to LHC and researches compliance related issues as requested by manager.
- Performs other duties as assigned by CCO or manager as needed or assigned within scope of position.
Education and Experience- BA|BS with an emphasis on nursing, healthcare administration or accounting.
- RHIA or RHIT, MHA or MBA is preferred
- Previous experience in a home health, hospice or hospital environment is preferred.
- Significant exposure to Medicare/Medicaid reimbursement and regulations, internal auditing, conducting investigations, healthcare, operations, Stark law, anti-kickback laws and fraud and abuse laws.
- Extensive Knowledge of Microsoft Office programs.
Company OverviewLHC Group is committed to a culture of diversity, equity and inclusion and is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any legally other protected characteristic.
LHC Group Inc Home Office a part of LHC Group family of providers – the preferred post-acute care partner for hospitals, physicians, and families nationwide. We deliver high-quality, cost-effective care that supports our patients when and where they need it. From our home health, hospice, and community-based services to inpatient care at our clinics and hospitals, our mission is to reach more patients and families with effective and efficient healthcare. More hospitals, physicians, and families choose LHC Group because we are united by a single shared purpose: It's all about helping people.
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