Compliance Auditor Job Description
Compliance auditor
provides general guidance regarding compliance with Code of Conduct and applicable federal, state and international laws and regulations as well as standards including, but not limited to, ISO 13485, Anti-Kickback Statute, FCPA, False Claims Act, etc.;.
Compliance Auditor Duties & Responsibilities
To write an effective compliance auditor job description, begin by listing detailed duties, responsibilities and expectations. We have included compliance auditor job description templates that you can modify and use.
Sample responsibilities for this position include:
Be a subject matter expert on PCI Standards and requirements
Review and investigate complaints related to health plan compliance received through regulatory agencies, internal departments, and business partners
Serve as a liaison between the Regulatory Compliance department and regulatory agencies for complaint-related correspondence
Monitor and prepare reports on compliance activities and other topics
Complete compliance audits and monitoring of various health plan operations
Prepare audit and investigation reports of findings and observations that identify, in detail, areas of non-compliance and risk areas for non-compliance
Review marketing materials for compliance with CMS and NYSDOH regulations
Submit marketing materials for review and approval by CMS and NYSDOH
Document all compliance activities in the Elderplan Compliance 360 database in accordance with department polices and/or workflows
Audit the IT and Business units’ infrastructure and processes for compliance against the PCI requirements
Compliance Auditor Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Compliance Auditor
List any licenses or certifications required by the position: ASQ, CHC, AHIMA, CHPC, HCCA, ISO, CIA, CRCM, CISA, ITIL
Education for Compliance Auditor
Typically a job would require a certain level of education.
Employers hiring for the compliance auditor job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Associate Degree in Accounting, Finance, Education, Business, Auditing, Healthcare, Business/Administration, Real Estate, Engineering, Management
Skills for Compliance Auditor
Desired skills for compliance auditor include:
CPT
General ledger/financial applications
Integrated packages
Microsoft applications
Standard phraseology used in title industry
DocuSign
Google suite
ISO 13485
Coding
Standards
Desired experience for compliance auditor includes:
Proficient with MS-Office Excel, Visio, PowerPoint
Supervision received typically consists of providing direction on the more complex issues and new job duties and priorities
Oracle Database Administration, Security Administration and e-Business Suite (a plus) Auditing
Bachelor’s degree and a minimum of four years regulatory examination oversight, compliance, or internal audit experience
Working knowledge of regulatory environment and applicable banking regulations impacting the financial services industry, including UDAP
Strong communication skills, experience collaborating with management, leading teams and managing projects
Compliance Auditor Examples
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Compliance Auditor Job Description
Job Description Example
Our company is growing rapidly and is looking to fill the role of compliance auditor. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for compliance auditor
- Provides management with periodic reports on compliance with federal, state, local laws, regulations, and ordinances, department and Company policies
- Act as the leader for internal audit teams and may participate in audits and inspections readiness activities for agency and third party inspections
- Ensure compliance to FDA and other worldwide health authority regulations/guidelines
- Assure McNeil’s management that the facilities and buildings, equipment, personnel, organization, methods, procedures (including warehousing and distribution), records, reports, and/or controls (including those controls of components, containers, closures, production, process packaging, labeling, and/or laboratory) are in conformance with applicable regulations
- Inform department and senior management of compliance findings, provides recommendations for corrective action and tracks corrective action commitments until closure
- Identify areas for process and other quality improvements
- Interface with management and leadership teams across McNeil sites and other J&J sites worldwide to achieve harmonization and standardization of practices and policies in order to improve core process reliability and efficiency
- Identify deficiencies and areas for improvement and coordinate with stakeholders to strategize those remediation methods and timelines to complete commitments
- Ultimately be responsible to the auditing organization for all phases of the Internal Audit program
- Have authority and responsibility to make decisions regarding the conduct of the audit and any audit observations
Qualifications for compliance auditor
- Atleast 1 year application of Business Controls Requirements
- Foundational understanding of business, industry and regulatory concepts within assigned LOBs
- Demonstrates ability to complete assignments by required deadlines
- Demonstrates basic business writing skills including strong grammar
- Bachelor's degree in Management, Accounting or law related field, or Finance preferred
- Independently performs initial survey and obtains background information relating to inquiries on activities and operations of a compliance nature by referring to and interpreting regulations, policies, and procedures
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Compliance Auditor Job Description
Job Description Example
Our company is searching for experienced candidates for the position of compliance auditor. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for compliance auditor
- Assists Department Managers in identification and development of underwriting file construction standards, trends and process improvement
- Researches, abstracts and communicates federal, state and payor documentation, billing and coding rules and regulations
- Investigate and resolve compliance concerns
- Review of relevant systems as assigned
- Document risks and mitigating controls through risk control matrices including evaluating control design and adequacy to ensure key risks are properly controlled and monitored, ensuring proper rationalization of controls
- Assist in establishing detailed audit programs to monitor and assess health plan operations and policies and procedures within all major functional areas including customer service, enrollment and eligibility and claims processing
- During audits, will review policies and procedures, works flows, organizational charts, encounter and claims related documents
- Develop draft reports as needed
- Development of audit programs, tools and templates to incorporate and apply sufficient working knowledge of trade controls, government contracting, and anti bribery and anti corruption
- Ability to work closely with corporate leadership and trade compliance teams and internal/external SME's
Qualifications for compliance auditor
- Prepare and submit compliance reports to the compliance committee
- Perform additional duties as assigned or directed
- Document and communicates risk assessment, including possible monetary impacts
- Participates on various committees and provides feedback to physicians, senior management and other staff
- Research government websites for regulatory (state and federal) updates and changes and communications with appropriate departments and leadership
- Independently conducts compliance reviews, special assignments, and research and advisory projects
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Compliance Auditor Job Description
Job Description Example
Our innovative and growing company is looking to fill the role of compliance auditor. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for compliance auditor
- Facilitating effective corrective/preventive actions
- Responsible for conducting non-routine audits, documenting & communicating findings and recommendations, explaining regulatory requirements, and overseeing the corrective actions for audits within the company
- Performs the actual monthly underwriting quality audits to ensure compliance with underwriting guidelines and other departmental procedures to promote underwriting excellence within the organization
- Performs the actual standard audits in most instances and special functions at the direction of the Chief Underwriting Officer or Chief Operating Officer
- Can organize data to generate standard and on request reports of audit findings for presentation and delivery to Department Managers, Senior Executives, and other internal groups
- Determines the content of the audit and number of files to be reviewed in each category
- Coordinates and manages all external carrier insurance company audits
- Communicates audit results action items to COO, CUO and monitors completion of identified follow up items
- Immediately alerts Chief Underwriting officer of any critical findings
- Protects the confidentiality of audit and other information learned by performing the duties of the position
Qualifications for compliance auditor
- Communicates effectively with medical staff and Business Services to acquire, interpret, and transmit accurate diagnostic and procedure information for billing
- Identifies opportunities for physician education to improve medical record documentation for severity of illness and level of service
- Independently travel to all off site hospital and clinics performing audits and education
- Ensure clinics and hospitals maintain compliance with applicable laws and regulations
- Assist with charge master and claim manager updates
- Serve as a resource to research billing criteria and reimbursement levels for new programs or services that a clinical or hospital department is implementing
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Compliance Auditor Job Description
Job Description Example
Our innovative and growing company is looking to fill the role of compliance auditor. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for compliance auditor
- Develop test plans and procedures to assess effectiveness of IT controls
- Perform IT compliance testing to assess risk, evaluate controls, safeguard assets, and analyze IT controls supporting financial reporting and operational processes
- Develop recommendations to mitigate risks or correct control deficiencies or gaps
- Monitor and track results of prior audits and compliance reviews, identifying themes across the organization to determine if appropriate corrective action has been taken regarding IT Audit or Compliance issues
- Communicate project status, concerns, or issues to Management in a timely manner
- Participate in special projects pertaining to IT Compliance initiatives
- Performs formal DOT Compliance audits at each DOT-regulated site addressing driver qualification (DQ) files, hours of service (HOS) records, hazardous materials shipping papers including common carrier manifests, vehicle maintenance records, site security, driver training, cargo tank certification and inspections, driver vehicle inspection reports (DVIRs), driver road tests, and DOT Special Permits
- Manages, administers and ensures DHS documentation is properly prepared for facilities affected by DHS requirements
- Performs individual store audits, following the approved Store Compliance Review
- Schedules individual store reviews to efficiently complete assignments
Qualifications for compliance auditor
- At least 1 year experience acting as liaison for government audits, including DCAA, DOE, IG, EPA
- Public Accounting or Internal Audit experience (minimum of 2 years)
- Experiences in handling Fraud Investigation/Whistle blower issues
- Excellent technical proficiency in auditing and data analysis
- Extremely proficient in Excel and/or other data analytics tools
- In depth knowledge of federal regulations
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Compliance Auditor Job Description
Job Description Example
Our company is growing rapidly and is looking to fill the role of compliance auditor. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for compliance auditor
- Conduct compliance auditing activities associated with clinical research studies that include but are not limited to the review of all research-related activities and documents to assess and evaluate the compliance of those activities to internal policies, standards operating procedures (SOP's), and relevant regulatory requirements
- Perform other duties and projects (not related to compliance auditing) such as Sarbanes-Oxley related testing (as may be necessary and assigned)
- Prepare clear and concise written reports on audit finding and conclusions and work with compliance stakeholders on the timely resolution and remediation of these
- Investigate reports of suspected or potential non-compliant activity
- Execute the Sarbanes-Oxley (SOX) walkthroughs and test plans for the company in a timely manner and in accordance with the testing calendar
- Developing detailed reports of reviews performed communicating pertinent information such as scope, objective, results, and recommendations/corrective actions plans, including researching relevant compliance guidance/reference to support
- Participating in the development of the annual corporate compliance and HIPAA work plans
- Ensuring adherence with annual compliance and HIPAA policy attestations
- Assisting in other compliance related functions including, on-going exclusion screening, conflict of interest reviews, compliance hotline investigations, updating policies and procedures and conducting exit interviews
- Follows standard protocols to conduct and complete timely audits for all facilities due to workplan, for-cause, or external request Accurately prepares descriptions of audit findings for operations, systems, and billing and provides recommendations for improvement or correction
Qualifications for compliance auditor
- Knowledge of Medicare/Medicaid regulations, including documentation requirements
- Candidate must be comfortable communicating with high level management and business owners across all departments in order to report status updates
- Candidate must be detailed oriented with execellent oral, written communication skills and interpersonal skills
- Candidate must have computer skills with MS Office and capable of quickly learning other software including Documentum, TrackWise and ComplianceWire
- Individual’s primary workstation is located in the office area, where the noise level is low
- Professional certifications related to audit, risk management and information technology, CIA, CISA, CPA