Senior Compliance Auditor

2 weeks ago

Lexington, Kentucky, United States Addiction Recovery Care Full time
Position Overview

Are you seeking a fulfilling career in a supportive environment? Addiction Recovery Care, LLC (ARC) has been recognized as one of the top workplaces in Kentucky, reflecting our commitment to employee satisfaction.

At ARC, we are dedicated to our mission of providing exceptional care and support to our clients, patients, and team members. As one of the fastest-growing healthcare systems in Kentucky, we specialize in addiction treatment and mental health services, striving to create opportunities for individuals to find hope and achieve their potential.

We are currently looking for a Compliance Auditor II to enhance our team. This role operates under the guidance of the Vice President of Compliance and is primarily responsible for conducting audits related to financial matters, specifically focusing on billing and coding accuracy. The Compliance Auditor II will evaluate the precision of the company’s claims records and ensure that safeguards are in place to prevent fraud, abuse, and resource wastage. Furthermore, this position will involve performing additional audit protocols to assess compliance in other identified risk areas.

Key Responsibilities:

  • Compile, analyze, and verify medical records and other relevant data to conduct thorough audits of client records in accordance with established policies and procedures.
  • Ensure the accuracy of facility records to protect against mismanagement and fraud.
  • Observe clinical service delivery to evaluate compliance with ARC policies, legal regulations, and accreditation standards.
  • Prepare and communicate audit findings and recommendations to management and facility staff in a timely manner.
  • Assist in the development and execution of audit recommendations and follow-up actions.
  • Conduct chart audits and monitor departmental action plans to ensure issues are addressed.
  • Audit patient accounts for accuracy and completeness of information.
  • Ensure correct coding on patient accounts.
  • Identify and report discrepancies promptly.
  • Maintain up-to-date knowledge of Medicaid requirements and regulatory guidance.
  • Foster collaborative relationships within the department and across the organization.
  • Demonstrate flexibility and organizational skills while managing stress effectively.
  • Adhere to policies, performance improvement objectives, and quality assurance initiatives.
  • Engage in ongoing education and professional development to stay current in the field.
  • Uphold patient confidentiality at all times.
  • Support a culture of safety and quality.
  • Perform additional duties as assigned.

Qualifications:

  • Experience in auditing and/or coding is required.
  • Background in healthcare or behavioral health settings is essential.
  • Strong communication skills, both verbal and written, with the ability to convey complex information effectively.
  • A post-secondary degree with relevant work experience is necessary.
  • Preferred experience in behavioral health environments.
  • Proficiency in information technology and knowledge of HIPAA compliance.

ARC offers comprehensive benefits packages for full-time employees, including health, dental, and vision insurance, as well as a 401(k) plan with company matching. We are committed to ensuring a healthy work-life balance through generous paid leave policies.

At Addiction Recovery Care, we are dedicated to transforming lives through strong family connections, social responsibility, and meaningful career opportunities.

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