Compliance Auditor

Description

About Jordan Valley Community Health Center:

Jordan Valley Community Health Center (JVCHC) is a mission-driven organization dedicated to improving the health of individuals and families in underserved communities. We provide comprehensive healthcare services including primary medical, dental, vision, and behavioral health. Our mission is simple: Improve our community’s health through access and relationships. By working collaboratively with partners and continually innovating, JVCHC strives to be a leader in providing essential healthcare for the underserved, ensuring everyone in our community has access to quality healthcare.

Job Summary

The Compliance Auditor is responsible for conducting E&M audits and ongoing review of 340B pharmacy program utilizing established criteria and auditing tools. The Compliance Auditor will be responsible for additional operational and compliance auditing processes to include reconciliation of any variances. The Compliance Auditor will also keep current with coding standards, and 340B regulations/program changes, policies and procedures, and understanding accessing and utilizing various vendor software products, as applicable.

Duties

• Completes compliance Evaluation and Management (E&M) documentation audits, and audits of the 340B pharmacies to promote documentation improvement and assure compliance with government oversight.
• Responsible for additional operational and compliance auditing processes as assigned, to include but not limited to reconciliation of variances, benchmarking, facilitation of peer reviews, and targeted service or business practice audits.
• Demonstrates proficiency with working within various Microsoft products such as Excel, and software systems including but not limited to electronic health record systems, 340B third party administrator software systems.
• Works with established 340B manager for cross training, reporting audit findings and providing follow up activities and reporting as requested.
• Initiates and implements training and education process improvements to achieve compliance and revenue enhancement for the organization when issues are identified in audits completed. This includes but is not limited to initial and on-going education with providers, and training and education as new service lines are implemented.
• Compiles audit results and creates requested reports tailoring to appropriate audiences. Identifies, reports and implements corrective action or education as appropriate.
• Provides routine benchmarking data to the providers and medical director for review and identifies areas for improvement, and provides education for achievement of this goal.
• Facilitates other on-going or periodic compliance audits as assigned per annual work plan following the same plan to include process improvement and education opportunities and implementation.
  
  

Benefits Overview

• Medical and Prescription Drug Coverage: Three comprehensive plan options (Buy-up, Base, and High Deductible) through UnitedHealthcare's Choice Plus network, covering various deductibles and out-of-pocket limits. Includes access to telemedicine services via Teladoc.
• Health Savings Account (HSA): Available for employees in the High Deductible Plan with employer contributions and tax advantages.
• Flexible Spending Account (FSA): Options for both healthcare and dependent care FSAs, allowing pre-tax contributions for qualified expenses.
• Dental and Vision Coverage: Dental insurance through Cigna’s DPPO network and vision coverage through EyeMed’s Insight network.
• Retirement Plan: Pre-tax and Roth 403(b) retirement plans with a 5% employer match starting after 30 days of employment.
• Life and Disability Insurance: Basic Life and AD&D insurance provided at no cost, with the option to purchase additional coverage. Long-term and short-term disability insurance are also available.
• Employee Assistance Program (EAP): Free confidential support for personal and professional challenges, including counseling and crisis intervention.
• Additional Voluntary Benefits: Options for critical illness, accident, hospital care, and pet insurance through MetLife.
• Pay On Demand Available
  
  

Holidays

• Nine paid holidays per year.
  
  

Health Requirements

All employees are required to provide proof of vaccination for Flu, Hepatitis B and Tuberculosis (TB) as part of our commitment to maintaining a safe and healthy workplace.

Application Process

Interested applicants should submit a resume and cover letter through the JVCHC career portal at Careers & Education - Jordan Valley. Applications will be accepted on a rolling basis until the position is filled.

Jordan Valley Community Health Center is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status.

Requirements

Required Qualifications:

• Minimum of two years in compliance/coding auditing.
  
  

Preferred Qualifications

• Associates/Bachelor’s Degree in Health Information Technology
• Certification in Healthcare Compliance (CHC) via Health Care Compliance Association (HCCA).
• Recognition as Certified Professional Coder (CPC) via AAPC or Certified Coding Specialist (CCS/CCS-P) via AHIMA.