Job details
Job type full-time
Full job description
Thank you for considering a career at ensemble health partners!
Under the direct supervision of the internal audit manager, this position contributes to the ensemble mission and vision by providing audit services related to ensemble revenue cycle-third party billing operationsThis position provides independent, objective assurance and auditing activity designed to add value and improve the organization`s operationsThe internal auditor will help the organization accomplish its objectives by bringing a systematic, disciplined approach to evaluate and improve the effectiveness of risk management, control, and governance processes.
Essential job functions:
Conducts operational, financial and/or compliance auditsThis includes annual soc certification as well as support service audits including it, hr, vendor management and finance/accountingUtilizes internal audit protocols specific to revenue cycle risk areas highlighted by the oig program guidelines for third party billing companies, state insurance fraud; managed care or governmental value-based payment programs and/or other enforcement agencies on behalf of clientsPeriodically review and analyze claims, denial reports, operational assessment reports, internal quality control reviews, internal and external third-party claims payments made available via ensemble’s proprietary system (eiq) or client host systemsThe purpose is to detect provider-billing trends, potential fraudulent or abusive billing practices or vulnerabilities indicative of potential underlying operational compliance issuesUtilizes data analytics techniques, statistical analysis and modeling, and databases developed internally, or in conjunction with other third-party vendors to detect and trend potential claims and billing compliance issues relative to revenue cycle risk areasMaintains awareness of regulations and current industry changes that may impact healthcare revenue cycle services through personal initiative, continuing education and peer-to-peer networkingCreates, and monitors to completion, service line corrective action plans (cap) derived from executed auditsDevelops educational content and trending of non-compliant activities to enhance proficiency and competency, understanding of standards and the consequences of non-compliancePrepares multi-faceted oral, written and electronic communications to facilitate discussion, networking, decision-making and proactive responses to meet current and emerging challenges among affected parties and entitiesEnsures that the internal audit management is apprised of local, remote and client-network emerging issues, adverse outcomes and/or deficiencies that could impact ensemble or client public statusAssociates may be required to perform other job related duties as required by their supervisor, subject to reasonable accommodation.
Employment qualifications:
Required minimum education: vocational/technical degree; specialty/major: healthcare auditing, healthcare, or him
Preferred education: 4 year/bachelor`s degree; specialty/major: healthcare administration, accounting
Licensing/certification preferred: cia, chiap, cisa, cpa
Minimum years and type of experience: 4 years healthcare revenue cycle operations, healthcare internal auditing, and/or information technology auditing.
Scheduled weekly hours:
40
Work shift:
All (united states of america)
We’ll also reward your hard work with:
Great health, dental and vision plans
Prescription drug coverage
Flexible spending accounts
Life insurance w/ad&d
Paid time off
Tuition reimbursement
And a lot more
Ensemble health partners provides reasonable accommodations to qualified individuals with disabilities in accordance with the americans with disabilities act and applicable state and local lawIf you require accommodation in the application process, please contact our human resources department at 877-692-7780 or recruitment@ensemblehp.com This department will make sure you get connected to a human resources representative that can assist you.
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