Emory Healthcare is looking for a Senior Compliance Auditor to provide expert leadership in evaluating and strengthening our organization's compliance program. This strategic role leads complex, risk-based audits across clinical, billing, privacy, and operational domains to ensure adherence to federal and state healthcare regulations.
What You'll Do
- Lead the development and execution of the annual healthcare compliance audit and monitoring plan based on enterprise risk assessments.
- Advise the Chief Compliance Officer, Compliance Committee, and executive leadership on regulatory risk exposure, audit findings, and remediation priorities.
- Provide mentorship and technical oversight to compliance auditors, analysts, or coders.
- Prepare and present executive and Board-level audit reports and trend analyses.
- Lead and perform audits to assess the design and effectiveness of internal controls, policies, and compliance safeguards in high-risk areas.
- Identify root causes, systemic risks, and potential overpayment exposure.
- Ensure audit workpapers meet legal defensibility and regulatory standards.
- Support internal investigations related to potential fraud, waste, abuse, or regulatory noncompliance.
- Assist with government audits, payer audits, RAC audits, and regulatory examinations.
- Support overpayment identification, quantification, and repayment in coordination with Legal and Finance.
- Oversee development and implementation of corrective action plans (CAPs).
- Validate remediation through follow-up audits and ongoing monitoring.
- Enhance continuous monitoring tools, dashboards, and audit methodologies.
- Partner with operational leaders to improve documentation, controls, and compliance culture.
- Travel to Emory Affiliated locations as required.
What We're Looking For
- Bachelor's degree in Healthcare Administration, Nursing, Health Information Management, Accounting, Finance, or a related field.
- 7 years of progressive experience in healthcare compliance auditing, internal audit, or regulatory compliance.
- Knowledge of Medicare and Medicaid billing rules.
- Knowledge of clinical documentation and coding standards.
- Knowledge of HIPAA Privacy and Security Rules.
- Knowledge of physician compensation and contracting requirements.
- Proven experience conducting risk-based compliance audits in a provider environment.
- Excellent ability to communicate complex compliance issues to clinical leaders and executives.
- Deep healthcare regulatory expertise.
- Clinical and operational acumen.
- Executive presence and judgment.
- Independence and objectivity.
- Advanced analytical and investigative skills.
- Ability to influence clinicians and administrators.
Nice to Have
- Master's degree (MHA, MBA, MSN, JD, or related).
- Experience in hospital systems, academic medical centers, or multi-site provider organizations.
- Familiarity with EHR systems, revenue cycle workflows, and clinical operations.
- Experience supporting OIG audits, DOJ inquiries, CMS surveys, or payer investigations.
- Professional certifications strongly preferred: CHC, CHPC, CHC-F, CIA, CPA, CFE, RHIA, RHIT, CCS, CPC.
Team & Environment
Reports to the Chief Compliance Officer or VP, Compliance & Integrity.
Benefits & Compensation
- Comprehensive health benefits that start day 1.
- Student Loan Repayment Assistance & Reimbursement Programs.
- Family-focused benefits.
- Wellness incentives.
- Ongoing mentorship, development, and leadership programs.
Work Mode
This is a hybrid position based in Atlanta, GA.
Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.