Company: GlobalHealth, Inc.
Location: Oklahoma City
Posted on: February 24, 2021
WHO WE ARE:As an industry leader, GlobalHealth is an
Oklahoma-Based health insurer covering individuals in all 77
counties. We aspire to be the employer of choice in our industry,
attracting and retaining a highly talented workforce. Our passion
is Genuine Care and Optimal Health for the members we serve. We are
unique by providing high touch, high value and a partnership to our
members. We go above and beyond to provide personalized, engaging,
and responsive services to our members. We work hard to offer
affordable health insurance coverage with the benefits people truly
want and need. It is our hope to be more than just a health
insurance company - we want to be long-term partners with our
members. We are looking for future employees who exude our core
values of taking accountability through ownership, being driven,
innovative and who have a passion for continuous learning. HOW WILL
THIS ROLE ADD VALUE TO THE ORGANIZATION?The successful candidate
will be responsible for completing compliance audits in accordance
with the GlobalHealth Compliance Plan. This includes, but is not
limited to: (1) defining the audit purpose, scope, and methodology
used; (2) conducting entrance conferences to explain the audit; (3)
obtaining the necessary information/data necessary to conduct the
audit; (3) drafting written reports that explain the rule,
regulation or policy being audited and the audit findings; (4)
making recommendations for corrective/remedial action; (5) timely
communicating significant obstacles or immediate concerns to
manager; and (6) presenting findings and recommendations to
stakeholders through exit conferences. ESSENTIAL JOB FUNCTIONS:
- Conduct compliance audits in accordance with the compliance
audit work plan and department policies and procedures. Participate
in the development of the annual audit workplan and quarterly
- Manage time efficiently to ensure audits and written reports
are completed timely.
- Prepare professional written reports of audit findings and
recommendations for corrective action.
- Create and maintain audit workpapers and records in accordance
with department record retention policies and regulatory
- Present audit findings and recommendations to management and/or
- Other projects and responsibilities as assigned. EDUCATION AND
- Bachelor's Degree required.
- Minimum three (3) years' auditing experience at a health
system, managed care organization, or healthcare audit consulting
firm. Experience in auditing medical billing, coding, or claims
processing strongly preferred.
- Working knowledge of the Medicare Advantage Program.
- Relevant certification preferred (e.g., CPC, RHIA, CIA, CHIAP,
CHC) KNOWLEDGE, SKILLS AND ABILITIES:
- Inquisitive mind with ability to spot issues or
- Strong analytical ability with attention to detail.
- Excellent verbal and written communication skills. Must be able
to write professional audit reports.
- Excellent computer skills (MS-Word, Excel, Outlook, etc.) with
ability to utilize analytical and statistical software tools.
Knowledge of claims/billing systems (e.g., EPIC, etc.) a plus.
- Ability to manage multiple priorities simultaneously and meet
- Ability to maintain a high-level of confidentiality. WORK
- Indoor office setting
- Prolonged sitting at a desk and using a computer. Frequent,
repetitive keyboard use TRAVEL: Some travel may be required - may
require overnight stay. Must have a valid driver's license and be
able to drive a car. SUPERVISORY RESPONSIBILITY: This position does
not have direct reports OTHER DUTIES: This job description is not
designed to cover or contain a comprehensive listing of activities,
duties or responsibilities that are required of the employee for
this job. Duties, responsibilities, and activities may change at
any time with or without notice.
Keywords: GlobalHealth, Inc., Oklahoma City , Compliance Auditor, Accounting, Auditing , Oklahoma City, Oklahoma
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