Audit Specialist

Job Details

Job Location

79 North Clinton Ave - Rochester, NY

Position Type

Full Time

Education Level

Bachelors Degree

Salary Range

$22.50 - $24.00 Hourly

Job Shift

Day

Job Category

Administrative/Clerical

Description

The Audit Specialist is responsible for identifying, auditing, analyzing, and reporting on patterns of regulatory risk, and providing recommendations for adhering to internal controls and regulatory requirements in Medicaid and non-Medicaid funded programs. The Audit Specialist will lead efforts to maintain an understanding of internal controls and regulatory requirements across the agency.

Essential Duties and Responsibilities

• Coordinates with Director of Compliance annual schedule of financial or operational audits.

• Examines data, evaluates information, communicates results and follows up on audits in accordance with the agency’s Corporate Compliance Plan, Federal and State Regulations and funder requirements. This includes Medicaid and private payor compliance and established billing and coding regulations

• Performs chart reviews as outlined in the annual audit schedule for client services based on the Agency Risk Assessment

• Prepares reports on internal and external audits, program monitoring visits and corrective action plans

• Investigates and monitors issues of non-compliance and coordinates with the program to implement appropriate internal controls

• Recommends future course of action based on audits and data analysis

• Conducts investigations into reported compliance concerns

• Assists in developing educational material related to documentation, compliance or procedures

• Conducts training and provides updates regarding internal controls and regulatory compliance

• Provides impartial and unbiased judgment in all aspects of job performance

• Adheres to all applicable federal and state laws, as well as CCFCS internal policies, including but not limited to those governing client confidentiality, privacy, program standards and billing and documentation standards

• Maintains high level of expertise in specialized areas through continuing education, individual contacts, and attendance at appropriate meetings

• Attend mandatory training.

• Actively pursues development of professional competencies related to job role performance through reading, supervision, in-service training and attendance at conferences and workshops.

• Assist Quality and Compliance Department with conducting client satisfaction surveys including compilation, analysis and communication of results.

• Attend staff meetings and other agency committee meetings as appropriate to duties and responsibilities and communicate information directly to appropriate staff.

• Represent Catholic Charities Family and Community Services on appropriate committees.

• Awareness and active support of the Agency's Mission, Vision, Values and Strategic Plan. Including, but not limited to, supporting the Agency's Core Competency initiatives of being Collaborative and Community Focused, Innovative and Entrepreneurial, and Culturally Competent and Diverse.

• Other duties as assigned

Note: The above description is illustrative of tasks and responsibilities. It is not meant to be all inclusive. Employees are required to follow appropriate supervisory direction and perform other related duties as required.

Qualifications

Education: Bachelor’s Degree in Human Services, Business Administration, or related field required. Equivalent combination of education and experience will be considered.

Credentials: N/A

Experience: Knowledge of regulatory guidelines and practices. Advanced knowledge of insurance billing and collection regulations and requirements. Experience in auditing for internal controls. Excellent verbal and written communication skills. Demonstrated proficiency with high attention to detail and maintaining confidentiality

Physical Demands/Work Environment: The physical demands/work environment described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently required to sit, talk, hear, stand, walk, use hands to type and/or perform light lifting. Specific vision abilities required by this job include close vision, distance vision and ability to adjust focus. The noise level in the work environment is usually quiet.

Compliance: Adheres to all applicable federal and state laws and regulations including, but not limited to, those governing confidentiality, privacy, program, billing, and documentation standards. All duties must be performed in accordance with CCFCS’s corporate compliance & ethics program.

Additional Requirements:

• Ability to prioritize assignments, plan, and complete work projects with minimal direction,

• An ability to work efficiently and effectively and meet deadlines,

• An ability to work under pressure,

• Excellent verbal/written skills,

• Ability to maintain confidentiality,

• Ability to demonstrate behaviors and attitudes which support agency mission, philosophy, and policies.

• Willingness and ability to foster agency and program wide cooperation and teamwork through use of positive/constructive communication techniques,

• Possession of a valid NYS Driver’s license and use of a registered and reliable vehicle.