Director Internal Audit - Revenue Cycle

About the role

Provides leadership and oversight for the Internal Audit program within an assigned area of responsibility. Directs and develops Internal Audit team members to ensure audits are conducted independently, efficiently, and with a high level of quality, integrity, accuracy, and professional judgment. Participates in enterprise risk assessment and development of the annual audit plan, leads and/or oversees complex audits, evaluates audit findings and remediation activities, and communicates significant risks and recommendations to management and governance. Establishes and maintains effective relationships with key partners, including Corporate Responsibility, Legal, Finance, Information Technology, Revenue Cycle, and other operational and clinical leaders. May provide specialized audit leadership and subject matter expertise based on assigned scope, including Revenue Cycle, Information Technology, financial, operational, compliance, or other areas of organizational risk.

Responsibilities

• Provides leadership and oversight of assigned Internal Audit activities, including directing, coaching, and developing staff and reviewing and approving audit workpapers and documentation to ensure compliance with Internal Audit standards and organizational requirements.
• Participates in enterprise risk assessment and audit planning, identifying and evaluating significant financial, operational, compliance, information technology, revenue cycle, and other organizational risks to inform development of the annual audit plan.
• Leads and/or conducts complex and high-risk audits in accordance with the approved audit plan, including defining audit scope and objectives, evaluating controls and processes, analyzing evidence, identifying risks and control deficiencies, and developing appropriate audit documentation.
• Evaluates audit findings and recommendations and works with management to develop appropriate action plans, including monitoring and validating remediation activities and reporting the status of outstanding issues.
• Prepares and communicates audit results to management and assists with the preparation and presentation of audit reports for senior leadership and governance committees, including communicating significant risks, findings, trends, and recommendations.
• Provides ongoing consultation and risk insight to management and key partners regarding internal controls, risk management, compliance, process improvement, and emerging areas of organizational risk while maintaining appropriate Internal Audit independence.
• Develops and maintains effective relationships with key stakeholders, including Corporate Responsibility, Legal, Finance, Information Technology, Revenue Cycle, and operational leaders, to facilitate timely communication, collaboration, and resolution of audit issues.
• Monitors industry trends, regulatory developments, and emerging risks relevant to assigned areas of responsibility and incorporates current knowledge, professional standards, and leading practices into audit planning and execution.
• Supports continuous improvement of the Internal Audit program by identifying opportunities to improve audit methodologies, processes, tools, reporting, quality, and efficiency.
• Maintains a commitment to professional excellence, demonstrating sound judgment, objectivity, confidentiality, accuracy, thoroughness, and integrity in the performance of all Internal Audit activities.

Requirements

• Bachelor's degree in business, accounting, finance, information systems, healthcare administration, or related field
• CPC, CCS, RHIA, or RHIT
• CIA, CISA, CPA, or other relevant professional certification preferred and/or required within two years of hire based on assigned scope
• 7+ years of progressive internal or external audit experience
• Experience leading complex audits, evaluating internal controls, assessing risk, and communicating audit findings to management

Revenue Cycle Internal Audit Scope Experience

• 7+ years of progressive audit experience, including significant experience with healthcare revenue cycle operations
• Demonstrated experience in one or more of the following: coding, billing, charge capture, claims, reimbursement, denials, revenue integrity, payment processes, or related healthcare compliance
• Experience leading audits involving complex revenue cycle processes, controls, and regulatory or reimbursement risk

Preferred Qualifications

• Master's degree
• CIA, CISA, CPA, CHIAP, CPMA, or other relevant professional certification
• Healthcare industry experience

Pay

Base Range: $143k - $185k

Benefits

• Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible)
• Medical, dental, vision, prescription coverage, HSA/FSA options, life insurance, mental health resources and discounts
• Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders
• Tuition assistance, professional development and continuing education support

Benefits may vary based on the market and employment status.