Compliance Auditor 1

2 weeks ago

Houston, United States The Harris Center for Mental Health and IDD Full time

Are you ready to make a real difference in people's lives? Join the as a **Compliance Auditor 1. **The Compliance Auditor 1 works under general supervision with moderate latitude for the use of initiative and independent judgment. This position provides coordination between the Authority and contracted services programs by conducting a technical review of medical records, billing service codes, contracts, and other documents. The Compliance Auditor 1 is responsible for carrying out programmatic and departmental goals and objectives as stipulated by Texas Administrative Code (TAC), Medicaid Guidelines, Texas Resiliency and Recovery Guidelines, and Quality Practices of the Agency. This position provides center-wider oversight to the Agency divisions related to compliance standards, state and federal guidelines, and contract requirements. Additionally, this position is responsible for preparing and scheduling ongoing audits, collaborating with managers, supervisors, and additional staff regarding compliance regulations. Travel is required.

**Your role in action**:

- Provides center-wide oversight which includes consultation to all program directors, managers, staff, and unit level program monitors.
- Conducts inter-rater reviews(review of unit level program monitor’s findings).
- Provides training/technical assistance and ongoing consultation to the IDD/MH/CPEP/Forensics Division and
- Units (inclusive of managers and staff).
- May participate in the hiring process of other program monitor positions as requested.
- Performs special tasks, develop new audit tools and revise/update current audit tools to reflect Agency P&P and state/federal guidelines.
- Completes reviews as assigned.
- Completes technical reviews of records assuring compliance with all applicable guidelines.
- Completes reviews of external contractors.
- Completes a written report (audit tools), preliminary debriefing reports and final debriefing reports.
- Reviews all deficiencies as cited and initiate Plans of Improvement (POI) if needed.
- Participates in additional reviews such as adhering to all State requests.
- Participates in Focus, Comprehensive, and Authority reviews.
- Participates with Agency committees or work groups, if applicable.
- Contacts sources to validate information received from case reading, sources, and consumers.
- Provides technical assistance to the IDD/MH/CPEP/Forensics Programs on compliance issues, identifies trends or problems, and recommends appropriate changes in service delivery.
- Provides input on the development of quality control policies, procedures, and protocols.
- Completes operational (site) reviews(IDD/MH)
- Participates in investigations as assigned regarding concerns within the Agency.
- Completes State Mystery caller reviews
- Coordinates and adheres to State Requests and Insurance requests.
- Participates in training and meetings to determine areas for compliance.
- Completes audits outside of normal business hours as needed.
- Follow’s up, logs and tracks compliant calls received in the Department.
- Follow’s up, logs and tracks incident’s reports received in the Department.
- Facilitates staff in-services on compliance policies, procedures and protocols/review tools.

**What qualifications you will need**:

- **Education**_**:

- Bachelor’s degree (B.A.) or equivalent
- **Experience**:_
- Two (2) years auditing experience
- **Knowledge, Skills & Abilities**:_
- Knowledge of federal program policies and laws, of financial and medical eligibility program policies, and of agency quality control procedures.
- Knowledge of Microsoft Word, Excel, Access, Power Point and Outlook.
- Knowledge of HIPAA Privacy and Security Rules.
- Possess strong verbal and written communication skills, and interact effectively at all levels within the organization.
- Ability to interpret policies and procedures, analyze and evaluate quality control case review documentation for accuracy and completeness, to analyze management problems and develop and present alternative solutions.
- Works with others in a collaborative manner. Actively participates as a member of the team.
- Demonstrates a commitment to and an integration of MHMRA values: Integrity, Accountability, Consumer Orientation, Quality, and Efficiency
- Must have well-developed interpersonal, organizational, and problem solving skills, and be a team player with a desire to provide a high level of customer service. Should have excellent written, verbal and communication. Ability to maintain absolute confidentiality of all work-related matters and ability to communicate effectively and tactfully with all levels of the agency.

**What else you should know**:

- This posting is associated with position #1017
- This position will be located at 9401 Southwest Fwy. Houston, TX 77074.

**What we have to offer**:
The HARRIS CENTER offers competitive salary, excellent benefits package, retirement plans with company matching, prior service credit towards gene

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