Under the direction of the MJHS Compliance Officer and working closely with members of the MJHS Compliance department, the Compliance Auditor for Hospice and Palliative Care is responsible for designing, planning and executing compliance audits to satisfy the requirements of the compliance program for MJHS Hospice and Palliative Care. Audits may consist of validation audits on claims, accurate coding of medical services rendered, provision of services specific to contractual requirements, etc. Internal audits may be conducted to determine if documentation is supportive of care delivered and with policies and procedures of MJHS Hospice and Palliative Care based on federal and state government and regulatory standards. The Compliance Auditor will provide ongoing monitoring of results and/or corrective action plans related to audit results which includes risk management activities of the Compliance Committees. The Compliance Auditor will work in conjunction with the MJHS Compliance Officer and MJHS Compliance department on the development of the Compliance work plan, staff education, risk area identification, analysis and reporting of the audit findings. The Compliance Auditor will monitor procedures to effectively perform duties independently that support the MJHS Compliance Program (including HIPAA Privacy activities). The Compliance Auditor must demonstrate extensive knowledge of Hospice and Palliative Care Medicare, Medicaid, and third party regulations, etc. The Compliance Auditor will assist in investigations of various compliance-related issues throughout MJHS Hospice and Palliative Care, along with other compliance-related activities as directed.
Bachelor's Degree required with Master’s Degree (completed or in progress) in business, accounting or a health-related field
Five or more years’ experience in compliance-related matters of the hospice industry, with keen auditing skills
Proficient and experienced with a strong working knowledge and interpretation of Hospice and Palliative Care regulations and/or industry guidance of clinical, finance, reimbursement, coding, etc., matters related to compliance
Ability to understand and interpret clinical documentation in patient medical record
Certification in Healthcare Compliance (CHC) and/or as Certified Hospice and Palliative Care Nurse (CHPN) is highly recommended
Evidence of ongoing Hospice and Palliative Care continuing education
MJHS is a charitable not-for-profit organization with more than a century of providing quality, compassionate and innovative health services to New Yorkers of all ages, ethnic, religious and economic backgrounds. MJHS is uniquely positioned to provide the right level of care when and where it is most needed—so the majority of its care recipients are able to continue living at home and we can help ...reduce hospital readmissions. The MJHS robust portfolio includes: home care, hospice, palliative care, centers for rehabilitation and nursing care, health plans, independent living and adult day health care. Interested in working at MJHS? Visit mjhs.jobs For general information, visit www.mjhs.org or call 1-855-692-5058.
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