
Internal Auditor
18 hours ago
Key responsibilities of a healthcare internal auditor:
- **Risk assessment**:Identify and assess potential risks within healthcare operations, including financial, compliance, clinical quality, and operational risks.
- **Internal control review**:Evaluate the effectiveness of internal controls over financial transactions, patient data, and clinical processes to prevent fraud and errors.
- **Compliance auditing**:Ensure adherence to healthcare regulations, such as HIPAA, Medicare coding guidelines, and state licensing requirements.
- **Medical record review**:Analyze patient medical records for accuracy in diagnoses, procedures, and billing codes.
- **Billing and coding audits**:Review patient billing practices for accuracy and compliance with billing codes, identifying potential over
- or under-coding issues.
- **Clinical quality audits**:Assess the quality of clinical care provided by reviewing patient records against established clinical standards.
- **Fraud investigation**:Investigate potential cases of fraud or abuse within the healthcare system, including patient identity theft and improper billing practices.
- **Reporting and communication**:Prepare detailed audit reports outlining findings, recommendations, and action plans to management and relevant stakeholders.
- **Follow-up on corrective actions**:Monitor the implementation of corrective actions to address identified issues and ensure ongoing compliance.
Required skills and qualifications:
- **Healthcare knowledge**:Thorough understanding of healthcare operations, medical coding, billing practices, and clinical documentation standards.
- **Audit methodology**:Expertise in internal audit methodologies, including risk assessment, control testing, and data analysis.
- **Analytical skills**:Ability to analyze complex data sets, identify trends, and draw meaningful conclusions.
- **Communication skills**:Effective communication skills to clearly present audit findings and recommendations to management.
- **Compliance knowledge**:Awareness of relevant healthcare regulations and compliance requirements
**Job Types**: Full-time, Permanent
Pay: ₹10,000.00 - ₹30,000.00 per month
**Benefits**:
- Provident Fund
Schedule:
- Day shift
Supplemental Pay:
- Performance bonus
- Yearly bonus
**Experience**:
- total work: 5 years (preferred)
Work Location: In person
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