PruittHealth Compliance Auditor - Nurse South Carolina in Columbia, South Carolina
Category : Clinical Services
Location/City : SC - Columbia
Id : 22544
Title: Hospice Compliance Auditor - NurseLocation: Columbia, SCPOSITION SUMMARY :The Compliance Auditor (CA) reports directly to the Executive Director of Compliance (EDC) to conduct utilization and compliance audits for Hospice facilities. The CA performs routine and focused internal compliance investigations, audits and assessments throughout the organization and develops detailed reports with recommendations to the EDC. The CA conducts research on complex issues and summarizes findings as requested by the EDC. This position requires an individual who is self-motivated, goal-oriented, and flexible to frequently shifting work priorities.ESSENTIAL JOB FUNCTIONS, DUTIES, AND RESPONSIBILITIES: Demonstrates excellent written and oral communication and organization skills. Demonstrates ability to work unsupervised and to prioritize and manage multiple assignments. Demonstrates good analytical and organizational skills and the ability to collect, analyze and utilize data. Possesses good interpersonal skills for effective liaison with department, company and agencies while maintaining objectivity, accuracy and confidentiality. Demonstrates knowledge of state and federal laws and regulations that apply to Hospice operations and billing requirements Demonstrate knowledge of organizational processes, policies, procedures and systems related to audits and utilization review for all business units. Demonstrates knowledge and ability to manage the Medicare and Medicaid denials and appeals process Demonstrates ability to perform and adequately document audits, including interviews, observations and record reviews timely. Performs internal compliance investigation and audits including compiling detailed reports with recommendations Demonstrates ability to work well both independently and with others. Demonstrates ability to develop or extract measurable standards from qualitative criteria. Demonstrates ability to assist with preparation of documents in response to external auditsLICENSURE, CERTIFICATION, EXPERIENCE AND EDUCATION REQUIREMENT
Must be a Registered Nurse in good standing in at least one of the states in which PruittHealth operates (GA,FL,NC,SC) Licenses will be required to be renewed appropriate following state regulations. Knowledge of State and Federal Regulations for Home Health and Hospice preferred. Experience working in a licensed and/or federally certified Hospice. Proven ability to work unsupervised and to prioritize and manage multiple assignments with integrity. Experience working with computers and varied computer programs (Microsoft Word, Excel, etc.) Excellent communication and organization skills. Partner must also have a valid driver's license and access to personal transportation. For immediate consideration, please click the "Apply Now" at the top right of this screen.We offer a progressive benefits program that reflects our commitment to caring for our 16,000 partners:* Partner Referral Program â Earn cash for referring licensed and certified candidates* Employer paid profit sharing* Employer matching 401(k)* Paid Time Off (PTO) accruals beginning the first day of employment* Access to "Purchasing Power" financial health program after one year of employmentAt PruittHealth, Committed to Caring isn't simply a tag line, it's the way we do business and it's ingrained in our culture. At PruittHealth, we don't hire employees â we welcome partners!Since its inception in 1969, PruittHealth has been a family-owned innovative organization committed to providing exceptional care across a wide spectrum of services including: skilled nursing care, assisted & independent living, home health care, end-of-life hospice care, rehabilitation, pharmacy/infusion services and more.
Today, the organization is the 14th largest skilled nursing provider in the United States, spans across the Southeast, touches 170 communities, cares for 24,000 patients daily, and is driven by 16,000 passionate partners.PruittHealth is an Equal Employment Opportunity employer and all qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability or veteran status.