Senior, Compliance Auditor

Overview

Be inspired.  Be rewarded. Belong. At Emory Healthcare. 

At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be.  We provide: 

• Comprehensive health benefits that start day 1 
• Student Loan Repayment Assistance & Reimbursement Programs 
• Family-focused benefits  
• Wellness incentives 
• Ongoing mentorship, development, and leadership programs  
• And more  

Work Location: Atlanta, GA

Description

• The Senior Compliance Auditor - Healthcare Provider provides expert leadership in evaluating and strengthening the organization's compliance program across clinical, billing, privacy, and operational domains.
• This role leads complex, risk-based compliance audits to ensure adherence to federal and state healthcare regulations and guidance from Healthcare Compliance Association, HHS-OIG, CMS, and other regulatory agencies.
• The position serves as a strategic advisor to executive leadership, clinical leaders, and the Compliance Committee.
• Strategic & Leadership
  • Lead the development and execution of the annual healthcare compliance audit and monitoring plan based on enterprise risk assessments 
  • Advise the Chief Compliance Officer, Compliance Committee, and executive leadership on regulatory risk exposure, audit findings, and remediation priorities
  • Provide mentorship and technical oversight to compliance auditors, analysts, or coders, as applicable 
  • Prepare and present executive and Board-level audit reports and trend analyses
• Healthcare Compliance Auditing
  • Lead and perform audits to assess the design and effectiveness of internal controls, policies, and compliance safeguards in high-risk areas identified in the risk assessment
  • Identify root causes, systemic risks, and potential overpayment exposure
  • Ensure audit workpapers meet legal defensibility and regulatory standards
• Regulatory & Enforcement Support
  • Support internal investigations related to potential fraud, waste, abuse, or regulatory noncompliance
  • Assist with government audits, payer audits, RAC audits, and regulatory examinations
  • Support overpayment identification, quantification, and repayment in coordination with Legal and Finance
• Corrective Action & Continuous Improvement
  • Oversee development and implementation of corrective action plans (CAPs)
  • Validate remediation through follow-up audits and ongoing monitoring
  • Enhance continuous monitoring tools, dashboards, and audit methodologies
  • Partner with operational leaders to improve documentation, controls, and compliance culture
• Additional Duties as Assigned
• Travel: Travel to Emory Affiliated locations as required
• Work Type: Hybrid employee - splits time between working remotely and working in the office

REQUIRED MINIMUM REQUIREMENTS:

• Education: Bachelor's degree in Healthcare Administration, Nursing, Health Information Management, Accounting, Finance, or related field
• Experience: 7years of progressive experience in healthcare compliance auditing, internal audit, or regulatory compliance

Knowledge, Skills & Abilities (required):

• Medicare and Medicaid billing rules 
• Clinical documentation and coding standards
• HIPAA Privacy and Security Rules
• Physician compensation and contracting requirements
• Proven experience conducting risk-based compliance audits in a provider environment
• Excellent ability to communicate complex compliance issues to clinical leaders and executives

Competencies:

• Deep healthcare regulatory expertise
• Clinical and operational acumen
• Executive presence and judgment
• Independence and objectivity
• Advanced analytical and investigative skills 
• Ability to influence clinicians and administrators

Preferred Qualifications:

• Education: Master's degree (MHA, MBA, MSN, JD, or related)
• Experience: in hospital systems, academic medical centers, or multi-site provider organizations
• Familiarity with EHR systems, revenue cycle workflows, and clinical operations
• Experience supporting OIG audits, DOJ inquiries, CMS surveys, or payer investigations
• Certification: Professional certifications strongly pr