Compliance Auditor

Overview

This role supports the Centers for Medicare and Medicaid Services (CMS) Benefits Coordination and Recovery Center (BCRC). The Compliance Auditor performs regular internal audits to research potential process issues, report findings, and recommend improvements to support adherence to compliance requirements under the Statement of Work (SOW), CMS Internet Only Manual (IOM), and other Medicare MSP Recovery statutes and guidelines.

Responsibilities

• Coordinate with the Prime accepting technical direction and provide analytical feedback; work closely with the Prime contractor’s Compliance Officer.
• Perform annual Risk Assessments and create the Certification Package for Internal Controls (CPIC) as required by IOM 100-06, Chapter 7, Internal Controls Requirements.
• Validate external audit findings, obtain management responses, and prepare summary audit reports.
• Assist in development and implementation of annual audit plans using an appropriate risk-based methodology.
• Assist the Compliance Officer with investigation of privacy incidents received via the compliance mailbox or anonymously through Navex Global, an independent reporting service.
• Assist with coverage of the compliance mailbox during business hours as needed.
• Investigate compliance-related complaints and concerns to help prevent potential compliance issues; report any significant suspected fraudulent activity to the Compliance Officer.
• Examine, test, and analyze internal controls; assess whether BCRC’s system of internal controls and risk management processes are adequate to ensure effectiveness and efficiency of operations, reliability of financial reporting, and compliance with applicable laws and regulations.
• Recommend improvements to internal controls and monitor significant and unresolved internal control weaknesses identified in prior audits.
• Monitor qualitative and quantitative standards established to meet contractual obligations and changing business requirements.

Requirements

• Ability to obtain and maintain the required customer clearance for access to systems, facilities, equipment, and property.
• Operational knowledge and understanding of Medicare policies and procedures.
• Experience working in Medicare Secondary Payer (MSP) related systems.
• Proficiency with Microsoft Office Suite.
• Detail-oriented with exceptional organization, analytical, problem-solving, and critical thinking skills.
• Excellent verbal and written communication skills, including presentation and reporting.
• Auditing experience required.

Education / Experience

• Bachelor’s degree (or equivalent work experience) and at least 4 years’ experience in MSP recovery.
• Degree in accounting and/or training in Medicare operations preferred.
• Auditing experience required.

Physical Demands

• Work is primarily performed in an office environment.
• Regularly required to sit.
• Regularly required to use hands to finger, handle, or feel, reach with hands and arms to handle objects and operate tools, computer, and/or controls.
• Required to speak and hear.
• Occasionally required to stand, walk and stoop, kneel, crouch, or crawl.
• Frequently lift and/or move up to 10 pounds; occasionally lift and/or move up to 25 pounds.
• Vision abilities required: close vision, distance vision, depth perception, and ability to adjust focus.
• Exposure to general office noise with computers, printers, and light traffic.

Compensation & Benefits

• Estimated pay range: $55,000 to $65,000. Final offer is contingent on location, skillset, and experience.
• Comprehensive benefits package includes:
  • Medical
  • Dental
  • Vision
  • 401(k)
  • Family Planning/Fertility Assistance
  • STD/LTD/Basic Life/AD&D
  • Legal-Aid Program
  • Employee Assistance Program (EAP)
  • Paid Time Off (PTO) and (11) Federal Holidays
  • Training and Development Opportunities

Location

• Not specified.

Equal Opportunity

• EOE including Disability/Vet.

Additional Information

• This is a drug-free workplace and adheres to the Federal Controlled Substance Act.
• Your application submission will be considered for all potential employment opportunities with Chickasaw Nation Industries (CNI).