[Hiring] Compliance Auditor @Chickasaw Nation Industries, Inc.

Role Description

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 make recommendations for improvements to facilitate successful adherence to the compliance requirements Statement of Work (SOW), CMS Internet Only Manual (IOM), and other Medicare MSP Recovery statutes and guidelines.

Qualifications

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

Requirements

• Must be able 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.
• Skilled proficiency with Microsoft Office Suite.
• Detail-oriented with exceptional organization, analytical, problem-solving, and critical thinking skills.
• Excellent verbal and written communications skills with solid presentation and reporting skills.
• Auditing experience is required.

Essential Duties and Responsibilities

• Works with the Prime accepting technical direction and providing analytical feedback. Works closely with the Prime contractor’s Compliance Officer.
• Performs annual Risk Assessments and creates the Certification Package for Internal Controls (CPIC) as required by IOM 100-06, Chapter 7, Internal Controls Requirements.
• Validates external audits findings, obtains management responses and prepares summary audit reports.
• Assists in the development and implementation of annual audit plans using an appropriate risk-based methodology.
• Assists the Compliance Officer with investigation of privacy incidents received via the compliance mailbox or anonymously through Navex Global, an independent reporting service.
• Assists with coverage of the compliance mailbox during business hours as needed.
• Assists in investigating compliance-related complaints and concerns, helping to prevent potential compliance issues from developing. Reports any significant suspected fraudulent activity to the Compliance Officer.
• Examines, tests, and analyzes internal controls. Assesses if the 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.
• Makes recommendations for improvement in internal controls. Monitors significant and unresolved internal control weaknesses in prior audits.
• Monitors qualitative and quantitative standards as established to meet contractual obligations and changing business requirements.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this job. Work is primarily performed in an office environment. Regularly required to sit. Regularly required 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. Must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, depth perception, and ability to adjust focus. Exposed to general office noise with computers printers and light traffic.

Benefits

• 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) – (11) Federal Holidays
• Training and Development Opportunities

EOE including Disability/Vet

The estimated pay range for this role is $55,000 to $65,000, with the final offer contingent on location, skillset, and experience.