Auditor

• Responsible for coordinating revenue integrity/ charge-related denials with Patient Business Service (PBS) center
• Ensures compliant & complete clinical documentation
• Assists with denials & related audits
• Identifies opportunities for revenue optimization
• Performs thorough and routine chart reviews
• Provides education to clinical colleagues & tracking of identified trends
• Leverages clinical knowledge & standard procedures to ensure timely attention to charge-related trends
• Responsible for retrospective charge reviews & assistance with third party charge audits
• Ensures tracking of all Revenue Integrity- related audits, identifying trends & collaborating with other Revenue Integrity, PBS & /or departmental colleagues on education & reporting to key stakeholders
• Collaborates with Revenue Integrity team on opportunities to improve & implement front-end process to support denial prevention

Revenue Integrity Nurse Auditor

• Join our dynamic Internal Audit (IA) team, where you will apply and develop expertise in our risk-based audit methodology, supporting engagements through their entire lifecycle - from pre-planning through execution and final report publication.
• You will gain unparalleled exposure to the Company’s complex and diverse operations, collaborating with cross-functional teams and senior leaders.
• Contributing to the assurance that our financial, operational, strategic, and compliance policies and procedures are effectively designed and operating as intended.
• Conducting in-depth client interviews to identify key business risks and their corresponding controls, applying analytical techniques to quantify potential impacts to the Company.
• Actively participating in critical communication and review forums with IA management, operational leadership, internal control partners, and other key stakeholders, fostering a collaborative and transparent audit process.
• Engage in a continuous learning environment, working on challenging projects that will expand your knowledge of the Company’s operations, automotive industry, and internal audit best practices.

• Collaborates with clinical documentation team in the review of inpatient accounts (with an emphasis on mortality reviews) identifying documentation improvement opportunities
• Assess DRG, PDx, secondary Dx, PCS, POA and all other components of documentation that impact quality metrics
• Consistently assures coding practices remain compliant with coding guidelines and regulations
• Continually identifies educational opportunities related to coding and documentation
• Expert educator to clinical teams and medical staff
• Identifies strategic plans that will result in a positive impact to the clinical dashboard
• Develops clinical relationships across the health system securing interdepartmental support necessary for successful implementation of education strategies assuring achievement of overall strategic targets
• Ability to multi-task a variety of audits
• Ability to analyze data and construct appropriate action plans
• Develops teaching tools to promote quality outcomes
• Is an active member of clinical and executive meetings as identified
• Advanced understanding of quality metrics for health system (Vizient, PSI, USNWR)
• Advanced understanding of clinical documentation and coding through the lens of local and national quality and ranking methodologies, including but not limited to, U.S News and World Report, Vizient, Leapfrog, the CMS Star Rating, and payer contracts and assists the Managers of Clinical Documentation and Coding in implementing key strategies to effect change.
• Partners with Coding, Clinical Documentation leadership and Medical Directors to coordinate, maintain, and execute advanced project work that includes but, is not limited to, Mortality Review, HAC/PSI Review, Quality Abstraction and Analysis, and/or special and non-traditional project work.
• Partners with NM departments that includes but is not limited to: IT; Analytics; and Innovation to design and implement new and advanced workflow solutions.
• Partners with third-party consultants/partners to contribute to workflow and methodology build and refine as necessary.

Coding Quality Auditor, Specialist

• The Technology Auditor will play a key role in the execution of the internal audit plan, providing a comprehensive perspective across Ford’s Automotive Technology domain.
• Engage with senior business and IT leadership through conducting audits to provide independent assurance on the effectiveness of internal controls and governance processes to manage risk within the assigned scope.
• Lead audit fieldwork, including planning, execution, and documentation of audit procedures, in accordance with Company and Internal Audit standards, ensuring quality and timeliness.
• Perform detailed testing and analysis to evaluate the design and operating effectiveness of internal controls.
• Develop and maintain strong relationships with key stakeholders, including operating partners and internal audit partners.

Technology Internal Auditor

• Provides safe, quality health care services & / or assistance to patients under the supervision & direction of a registered nurse or other designated health care professional
• Performs clinical care activities (direct or indirect) for patients within the “scope of practice” laws & training received
• Cares for patients safely by assisting in clinical care services or engaging in administrative activities
• Communicates effectively and respectfully
• Performs work in a safe, engaging, & supportive manner
• Maintains knowledge of applicable federal, state & local laws
• Performs nursing interventions or clinical knowledge application in decision-making
• May administer medication & carry out therapeutic treatment within scope of license
• Advocates for patients & informs patients and families about care details
• Collaborates with Revenue Integrity team on opportunities to improve & implement front-end process to support denial prevention

Nurse Auditor, Revenue Integrity

• Responsible for delivering BSI’s audit services to assigned clients
• Manage a portfolio of assigned clients based on location
• Conduct various types of audits as Team Leader or Team Member
• Monitor the client accounts to ensure client satisfaction is maintained
• Follow the training plan developed by the Scheme Director
• Lead teams when necessary, mentor, and coach new or inexperienced colleagues

Automotive Management Systems Auditor

• Develop audit plans, including identification of risk and control procedures to test
• Maintain and update risk and control matrices for assigned audits
• Ensure adequate testing coverage and appropriate workpaper documentation
• Interpret data and analyze results using analytic tools and techniques
• Support, and at times, lead status meetings with the auditee
• Assist the Lead Auditor in drafting audit issues, ensuring the root cause is accurately identified and addressed in the related management action plan
• Assist the Lead Auditor in the drafting of the audit report
• Support the timeline for audit planning, execution, and reporting
• Build strong relationships with the business and service lines
• Participate in ongoing professional development
• Serve as a brand ambassador for GMAS

Financial Auditor

• Leads and performs complex internal audits and coordinates related large-scale projects.
• Identifies, documents, and analyzes audit findings and develops audit programs that address and test identified key risks.
• Performs follow-up audits and monitoring to ensure appropriate adherence to policies and procedures.
• Monitors compliance with regulations and controls by examining and analyzing records, reports, operating practices, and documentation.
• Evaluates opportunities for improvement, develops recommendations, and presents improvement opportunities/audit findings to leadership.
• Acts as a resource to educate, consult and collaborate with staff on various audit related topics.
• Guides and educates departments on methods to decrease risk and increase compliance in organizational-wide programs, policies, and procedures.
• Assists the independent external auditors by gathering information, answering questions, executing testing, coordinating any further assistance needed, and performing related projects.
• Assists with establishment of annual audit plans by leading discussions with management to identify timing, scope and objectives of audits.
• Assists with the coordination of risk models/assessments to identify and develop an audit plan to address potential risks for specific audit scope areas.
• Ensures alignment of audit and project plans with risk assessment.

Senior Internal Auditor – Compliance

Coding Quality Auditor and Specialist

• Provides safe, quality health care services & / or assistance to patients under the supervision & direction of a registered nurse or other designated health care professional.
• Performs clinical care activities (direct or indirect) for patients within the “scope of practice” laws & training received.
• Cares for patients safely by assisting in clinical care services or engaging in administrative activities (e.g., maintaining records or supplies).
• Knows, understands & incorporates basic or essential area of practice (document, coordinate, communicate) & training standards.
• Uses clear, effective, respectful language & communication methods / means.

Nurse Auditor – RIO

• Audit planning & execution: Plan and conduct complex financial and operational audits, ensuring compliance with internal policies, procedures, and regulatory requirements.
• Risk assessment & control evaluation: Identify key risks and assess the effectiveness of internal controls, recommending enhancements to mitigate risks.
• SOX compliance testing and reviews: Participate in Sarbanes-Oxley (SOX) compliance testing and ensure adherence to regulatory guidelines using AuditBoard.
• Audit reporting: Prepare clear and concise audit reports summarizing findings, recommendations, and actionable insights. Present reports to senior management and the audit committee.
• Leadership & guidance: Provide mentorship and direction to junior auditors, fostering growth and collaboration within the audit team.
• Operational audit collaboration: Use SharePoint to manage and collaborate on operational audit workflows.
• Monitor recommendations & maintain tracking system: Manage the tracking system to document findings, recommendations, and follow-ups, ensuring corrective actions are implemented and sustained improvements achieved.

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