Corporate Compliance

3 weeks ago


Wilmington DE, United States ChristianaCare Full time

ChristianaCare is searching for a Corporate Compliance & Privacy Auditor to join the team.This position will execute moderate-to-complex level audits and participate in the evaluation of the adequacy, effectiveness, and efficiency of internal controls and identify weaknesses, along with providing recommendations to mitigate those weaknesses. This position is required to be able to work under limited supervision.

Education and experience requirements:

At least one of the following degrees is required:

  • Associates or Bachelor's degree in Nursing (active/unrestricted license)

  • Associate or Bachelor's degree in Health Information Management (RHIA or RHIT)

  • Equivalent experience of 5+ years' experience in provider auditing, claims auditing, compliance auditing, quality assurance, and/or recovery auditing

  • Coding Certification (at least one of the following are required and are to be maintained as a condition of employment)

  • Certified Professional Auditor (CPMA); Certified Professional Coder (CPC); Certified); Certified Coding Specialist (CCS); In-depth knowledge of ICD CM, ICD PCS and CPT/HCPCS coding systems.

  • Must be proficient in DRG/APC structure, National Correct Coding Initiatives, ICD CM/PCS Official Guidelines, Outpatient Prospective Payment System and Coding Clinic References. Current working knowledge of encoder/grouper. Strong analytical and communication skills.

  • Candidates who hold a CCDS or CPC will be given consideration but will need to obtain an inpatient coding certification within 1 year of their hire date with the company.

  • Experience in auditing education techniques and methods preferred, but not required.

Principal duties and responsibilities:

  • Review documentation to ensure appropriate assignment of DRG, ICD-9 codes, CPT codes, and modifiers for facility-based and provider-based clinical documentation, medical necessity, and/or inpatient coding and has a high level of understanding in reimbursement guidelines specifically an understanding of the MS-DRG, AP-DRG and APR-DRG payment systems.

  • Maintain a working knowledge of coding guidelines, HIPAA, and CMS regulations.

  • Participate in the planning and scheduling of compliance projects.

  • Work closely with providers to ensure accuracy in the coding and documentation of service.

  • Train new providers in coding and documentation responsibilities.

  • Research compliance related coding questions upon request from departments and/or practices.

  • Identify and report potential audit and compliance risks.

SPECIAL REQUIREMENTS:

Must maintain current AAPC certification.

When you become an employee at ChristianaCare, you are joining a robust healthcare organization that truly cares about their patients and their caregivers. For the second consecutive year, Forbes magazine has ranked ChristianaCare as one of the best large health systems to work for in the United States Guided by excellence and love, our Caregivers enjoy a multitude of employee benefits that include:

  • Full Medical, Dental, Vision and other insurance benefits

  • 403 (b) with an employer match

  • Generous paid time off with annual roll-over and opportunities to cash out

  • 12 week paid parental leave

About Christiana Care:ve

Headquartered in Wilmington, Delaware, ChristianaCare is one of the country’s most dynamic health systems, centered on improving health outcomes, making high-quality care more accessible and lowering health care costs. ChristianaCare includes an extensive network of outpatient services, home health care, medical aid units, two hospitals (1,227 beds), a Level I trauma center and a Level III neonatal intensive care unit, a comprehensive stroke center and regional centers of excellence in heart and vascular care, cancer care and women’s health. ChristianaCare is a not-for-profit teaching health system with more than 260 residents and fellows. We are continually ranked by US News & World Report as a Best Hospital. With our unique, data-powered care coordination service and a focus on population health and value-based care, ChristianaCare is shaping the future of health care.


  • Corporate Compliance

    3 weeks ago


    Wilmington, DE, United States ChristianaCare Full time

    ChristianaCare is searching for a Corporate Compliance & Privacy Auditor to join the team.This position will execute moderate-to-complex level audits and participate in the evaluation of the adequacy, effectiveness, and efficiency of internal controls and identify weaknesses, along with providing recommendations to mitigate those weaknesses. This position is...

  • Corporate Compliance

    3 weeks ago


    Wilmington, United States ChristianaCare Full time

    ChristianaCare is searching for a Corporate Compliance & Privacy Auditor to join the team.This position will execute moderate-to-complex level audits and participate in the evaluation of the adequacy, effectiveness, and efficiency of internal controls and identify weaknesses, along with providing recommendations to mitigate those weaknesses. This position is...

  • Compliance Manager

    5 days ago


    De Soto, United States Reach Recruiting Full time

    The Compliance Manager plays a crucial role in our restaurant franchisor business, ensuring adherence to regulatory requirements, brand standards, and ethical practices. They are responsible for developing and implementing compliance programs, policies, and procedures to mitigate risk and maintain a culture of integrity across the franchise network. The...


  • Wilmington, United States Intertrust Group B.V Full time

    Compliance/AML Administrator Wilmington, DE (In-office minimum 2 days per week) Monday-Friday, 8:30am-5:30pm This position will work closely with the business by coordinating reporting and supporting the delivery of AML Reporting & Compliance Services to client entities to ensure adherence to Cayman Islands legislative and regulatory requirements. Some...


  • Wilmington, United States Intertrust Group B.V Full time

    Compliance/AML Administrator Wilmington, DE (In-office minimum 2 days per week) Monday-Friday, 8:30am-5:30pm This position will work closely with the business by coordinating reporting and supporting the delivery of AML Reporting & Compliance Services to client entities to ensure adherence to Cayman Islands legislative and regulatory requirements. Some of...


  • Wilmington, United States WSFS Bank Full time

    Job Description At WSFS Bank, we empower our Associates to grow their careers, guide our customers to secure their financial futures, and actively support our Communities so they can fully thrive. Careers with WSFS Bank offer an inclusive and supportive culture, competitive salaries, advancement opportunities, and more. We are the region's locally...


  • Wilmington, United States WSFS Bank Full time

    Job Description At WSFS Bank, we empower our Associates to grow their careers, guide our customers to secure their financial futures, and actively support our Communities so they can fully thrive. Careers with WSFS Bank offer an inclusive and supportive culture, competitive salaries, advancement opportunities, and more. We are the region's locally...


  • Wilmington, United States CSC (Corporation Service Company) Full time

    **Associate Customer Service Associate** **_Monday - Friday, 8am-5pm _** **_Onsite _** **_Wilmington, DE _** As a Customer Service Associate, you will be part of our Compliance Mail team. This team supports our fast and reliable Registered Agent service, and team members use critical thinking and focus to analyze and extract pertinent information from...


  • Wilmington, United States WSFS Financial Full time

    Job Description At WSFS Bank, we empower our Associates to grow their careers, guide our customers to secure their financial futures, and actively support our Communities so they can fully thrive. Careers with WSFS Bank offer an inclusive and supportive culture, competitive salaries, advancement opportunities, and more. We are the region's locally...


  • Wilmington, United States WSFS Bank Full time

    Job Description At WSFS Bank, we empower our Associates to grow their careers, guide our customers to secure their financial futures, and actively support our Communities so they can fully thrive. Careers with WSFS Bank offer an inclusive and supportive culture, competitive salaries, advancement opportunities, and more. We are the region's locally...


  • Wilmington, DE, United States M&T Bank Full time

    Overview: Manages client relationships and daily administration of assigned Global Capital Markets (GCM) accounts of significant intricacy, complexity and risk, including all administrative, operational and risk management activities for GCM transactions.  Serves as main point of contact with the client and internal and external service partners to follow...


  • Wilmington, Delaware, United States Incyte Corporation Full time

    Overview: Incyte is a biopharmaceutical company focused on the discovery, development, and commercialization of novel medicines to meet serious unmet medical needs in oncology and inflammation and autoimmunity. Incyte is committed to the rigorous pursuit of research and development excellence to improve the lives of patients, make a difference in health...


  • Wilmington, United States UniFirst Full time

    UniFirst Corporation, a leader in uniform service, is seeking an energetic Environmental Engineering Co-Op to join the Environmental, Health and Safety team based at its corporate headquarters in Wilmington, MA. This individual will be involved various activities, including: Researching environmental regulations Compiling and evaluating environmental...


  • Wilmington, United States ESR Healthcare Full time

    Experience level: Mid-senior Experience required: 10 Years Education level: Bachelor’s degree Job function: Accounting/Auditing Industry: Accounting Compensation: View salary Total position: 1 Visa : Only US citizens and Greencard holders The Role and Responsibilities DuPont Finance has an experienced State Tax Manager position available at its corporate...


  • Wilmington, United States ESR Healthcare Full time

    Experience level: Mid-senior Experience required: 10 Years Education level: Bachelor’s degree Job function: Accounting/Auditing Industry: Accounting Compensation: View salary Total position: 1 Visa : Only US citizens and Greencard holders The Role and Responsibilities Finance has an experienced State Tax Senior Manager - Hybrid position available at its...

  • Director of Finance

    1 week ago


    Wilmington, United States Resources For Human Development Full time

    Description The Director of Finance and Operations is responsible for managing the financial operations for the IDD Division of RHD, including budget preparation, forecasting, and financial reporting. The Director is responsible for the monitoring and implementation of internal controls to ensure the functional areas are operating in accordance with...


  • Wilmington, United States Alkermes Full time

    * This position is located in Wilmington, Ohio The Director, Environment, Health, Safety (EHS) will provide strategic leadership regarding all aspects of EHS in our Wilmington manufacturing facility. The role-holder will influence and collaborate with stakeholders across the site to establish business-integrated strategies, management systems and programs...

  • Clamp Operator

    1 week ago


    Wilmington, United States Hood Packaging Full time

    Hood Packaging Corporation has a rich history in North America as a leader in the packaging industry. From day one, our company has been at the forefront in the design and manufacture of a wide range of packaging materials. Our goal at Hood Packaging is to provide a product that is manufactured in a safety conscious environment with attention to high...


  • Wilmington, United States UniFirst Full time

    UniFirst Corporation, a leader in uniform service, is seeking an energetic Environmental Engineering Co-Op to join the Environmental, Health and Safety team based at its corporate headquarters in Wilmington, MA. This individual will be involved various activities, including: Researching environmental regulations Compiling and evaluating environmental data...

  • Link B Operator

    1 week ago


    Wilmington, United States Hood Packaging Full time

    Hood Packaging Corporation has a rich history in North America as a leader in the packaging industry. From day one, our company has been at the forefront in the design and manufacture of a wide range of packaging materials. Our goal at Hood Packaging is to provide a product that is manufactured in a safety conscious environment with attention to high...