Medical Records Auditor (Compliance)

Description

At CTSHealth, our vision is to improve the quality of life for children who have experienced unfortunate situations beyond their control. We employ hard-working, dedicated, caring team members who are committed to excellence and empowering children and families through therapy, education, and prevention-based care.  

Compliance Auditor  

Gastonia, NC 

Full-time 

Hybrid -  3 days in the office/2 days WFH 

What will you do?  

The Compliance Auditor safeguards agency standards by ensuring compliance with established external and internal control procedures, and regulations. 

The Auditor reviews charts to assure compliance with established North Carolina licensure standards, CARF accreditation measures, and North Carolina Medicaid regulations.  The Auditor is part of the Risk Management and Compliance department and is an essential part of the CTS Compliance program. The review of documentation particular to North Carolina is key to the role as is the preparation of tracking and deficiency reports.  

Auditor Job Duties: 

• Ensures compliance with established external and internal control procedures by examining records, reports, operating practices, and documentation. 
• Verifies compliance through comparison of documentation to established policies, procedures and regulations. 
• Completes audits through hands-on, on-site review of consumer charts and assisting with Plan of Correction and follow-up. 
• Appraises adequacy of internal control systems by completing audit checklists. 
• Maintains internal control systems by updating audit programs and checklists, recommending new policies and procedures to the Policy Review Committee. 
• Communicates audit findings by preparing monthly reports. 
• Prepares special audit and control reports by collecting, analyzing, and summarizing operating information and trends. 
• Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks. 

Responsibilities and Duties 

• Identifies potential areas of compliance vulnerability and risk; assist in developing/implementing corrective action plans for resolution of problematic issues and provides general guidance on how to avoid or deal with similar situations in the future. 
• Helps monitor the overall performance of the Compliance Program and relates activities on a continuing basis, taking appropriate steps to improve its effectiveness. The core auditor duties will include:  
• Reviews Initial documentation 
• Reviews annual intakes 
• Keep track of annual intakes due dates 
• Request corrections on documentation. 
• Audit consumer files for completeness and against established standards. 
• Cross departmental communication and coordination  

Communication: 

• Work with a team approach with other employees to ensure agency compliance. 
• Report critical concerns and problems to Supervisor in a timely manner and actively seek 
• Supervisor’s input and assistance to Resolving the concern.  
• Follow chain of command when encountering problems or other areas of need and correct 
• problems requested. 
• Solicit and cooperate with the assistance of all support staff. 
• Actively participate in an appropriate manner with the decision-making process as “pro-active” 
• team member and cooperate with team’s decision, whether programmatic or clinical.  
• Provide coverage on-site or as assigned by the needs of the agency.  
• Attend staff meetings, planned in-service training, on-going training and any other regular or 
• assigned meetings. 
• Responsible for any equipment assigned to perform duties.  
• Facilitate flow of information. 

Requirements

 What qualifications do you need? 

• Education: A bachelor’s degree required.  
• Experience: A minimum of 5 years’ experience in a healthcare organization, to include demonstrated familiarity with residential and outpatient program operations including Foster Care, quality assurance, and state regulations is a must. Preferred credentialing as a QMHP or QDDP.  
• Qualifications: 
• Successfully pass criminal records check, finger printing, and HCPR check as a prerequisite for employment consideration. 
• Must successfully complete all core required training and updates as needed. 
• Must have reliable transportation, maintain required level of vehicle insurance and valid driver’s license. 

Auditor Skills and Qualifications 

• Must be available to travel. Complete CTS Orientation along with the following- CPR/