LEAD - INTERNAL AUDITOR

5 days ago

San Antonio TX, United States CFS Full time

LEAD - INTERNAL AUDITOR Hybrid - San Antonio, TX (On-site as needed)
Lead - Internal Auditor
Multi-Site, Multi-Specialty Healthcare

Audit Leadership & Oversight

Lead and execute moderate to complex internal audits, investigations, and consulting engagements across hospital departments, outpatient clinics, and surgical practices.
Ensure audits comply with healthcare regulations (e.g., CMS, HIPAA, Joint Commission standards) and internal policies within prescribed deadlines.
Validate audit findings with clinical, administrative, and operational leaders to ensure recommendations are practical, sustainable, and aligned with patient care standards.
Mentor junior audit staff and contribute to team development and knowledge sharing.
Stakeholder Engagement & Risk Assessment

Build and maintain strong relationships with clinical and administrative stakeholders to facilitate audit execution and promote a culture of compliance.
Conduct risk assessments and identify auditable activities across diverse specialties including surgery, radiology, cardiology, and primary care.
Monitor evolving healthcare risks and regulatory changes to inform audit planning and prioritization.
Audit Planning & Execution

Conduct interviews and walkthroughs with clinical and operational teams to understand workflows, billing practices, and compliance risks.
Design and document audit programs and test plans tailored to healthcare operations, including patient billing, coding accuracy, inventory controls, and clinical documentation.
Perform testing using data analytics and sampling techniques to evaluate control effectiveness and regulatory compliance.
Revenue Cycle Management (RCM) Audits

Audit end-to-end revenue cycle processes including patient registration, insurance verification, charge capture, coding, billing, claims submission, payment posting, and denial management.
Evaluate internal controls over RCM to ensure accuracy, timeliness, and compliance with payer requirements and reimbursement guidelines.
Identify inefficiencies, revenue leakage, and compliance risks within RCM workflows and recommend corrective actions.
Collaborate with finance, billing, and clinical teams to ensure audit findings are actionable and aligned with operational goals.
Prepare clear, concise audit documentation and reports that support observations and conclusions, adhering to internal standards and healthcare audit protocols.
Ensure timely completion of audit deliverables and follow-up on corrective actions to confirm resolution of identified issues.
Bachelor's degree in accounting, Business, Finance or related field is required. CPA, CIA, CISA, CFE, or relevant audit certification or a candidate to obtain a certification.
7+ years of Audit experience + Healthcare / Medical Industry experience preferred
#AUDIT #CISA #CPA #CIA #CFA #RISK #CONTROLS #OPERATIONALAUDIT #PERFORMANCEAUDIT #COMPLIANCE
Click here to apply online

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