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Additional Compliance Resume Samples
Compliance Auditor Resume Samples
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0-5 years of experience
Completed funding checklist and approved wire requests. Received two additional merit raises for excellent servicing and production.
- Performed compliance audits. Recognized by supervisors for consistency and getting job done.
- Reviewed all Insured Protection letters. Decreased errors by 25% that allowed team to receive
- Prepared and distributed state required disclosures.
- Reviewed Good Faith Estimates to ensure compliance with government regulations. Trained all
- Ordered all office and equipment supplies. Reduced supply cost by 20%.
- Facilitated all equipment maintenance request
0-5 years of experience
Drafted compliance audit plan; Established monitoring schedule for Federal and State grants
- Implemented standard grant procedures and controls to be used by all divisions
- Developed monitoring procedures to be used by the Grants and Contracts Office
- Conducted review of division with $10 million in Federal and State expenditures; Noted multiple issues and recommended corrective action
- Led the internal control risk assessment team; Completed compliance risk assessment
- Designed questionnaire to identify risks at the division level
- Interviewed division personnel; Identified weaknesses and the need for entity-level controls
6-10 years of experience
Perform an average of 75 onsite facility audits annually of hospital and community health center pharmacies for fiscal, operational, and procedural compliance to Pharmaceutical Institutional Bulk Replacement Program standards.
- Confirm accuracy of onside patient information including acceptable documentation for income, residency and insurance status (i.e., Governmental Aid, Commercial Insurance, Medicare, Medicaid and Affordable Care Act)
- Guide facility health professionals in the optimization of EMR and Pharmacy databases to improve quality improvement metrics.
- Interact with physicians, pharmacists, pharmacy technicians and nurses in order to provide recommendations and program enhancements.
- Prepare final audit summary reports outlining audit findings and provide results to drug manufacturers in order to determine eligibility renewal.
- Identified and recommended new revenue streams from existing business lines for a business growth of thirty percent (30%) in 2013 and a projected growth of forty-five percent (45%) in 2014.
- Completed one hundred percent (100%) of field audits within time and budget guidelines.
0-5 years of experience
Partnered with Internal Auditors to ensure compliance for all Student Finance files
- Worked with National Auditors to address specific requests and questions regarding student files
- Managed Federal Work Study awards for 120 campuses to ensure funds were accurately processed
- Partnered with campus Presidents and Directors to ensure compliance between campus and Student Finance
- Created Internal Audit reports
- Oversaw Student Finance Representatives and audited their work for quality and compliance
0-5 years of experience
Analyzed rules and regulations when determining Housing and Urban Development compliance guidelines.
Traveled 50% annually to administer compliance reviews to grantees. Completed 90% of my compliance
reviews in less than one week.
- Conducted on-site reviews of multifamily housing assisted with Housing Assistance Payments
- Proficient knowledge and certification in Fair Housing, Equal Credit, and Civil Rights.
- Maintained effective working relationships primarily by providing technical support to owners,
0-5 years of experience
Performance-focused leader with a ten year track record of driving operational improvements that result in profit growth, increased productivity, and enhanced business practices. Champion of developing performance-based, low-cost solutions for the financial industry. Highly effective problem solver with expertise in regulatory compliance, financial and operational management.
- Forged new Management Programs by aligning bank priorities with the bank’s goals.
- Implemented new compliance procedures that resulted in an improved overall compliance rating for the bank.
- Developed enhanced auditing procedures to comply with changes in the regulatory environment.
- Implemented new Management Reports to the Board of Directors that improved the Board of Directors ability to manage the bank.
6-10 years of experience
- Auditor: Enforced security compliance globally via audits of technology accounts using SQL and Excel for various applications.
- Process Improvement: Created and implemented automated processes for the global audits.
- Trainer: Created detailed documentation and provided training for team members on tasks considered level 1.
- Globalization: Created a global asset loss process and performed a weekly compliance report using Pivot tables to capture global improvement and compliance.
- Leader: Held weekly conference calls and presentations with the global management members for the new global asset loss process
0-5 years of experience
Responsible for managing internal and external audits, interpreting policy and working with Senior Leadership to mitigate risk.
- Achieved 1 club rating for site each year
- Improved Divisional Internal Audit score from a 2.8% to 2.3% within three month period
- Developed and implemented Self-Audit program to identify potential risk
- Developed reporting and tracking system to communicate audit scores and effectiveness of corrective action plans
- Worked with Senior Leadership in multiple departments to calibrate training and procedure implementation
- Developed QA program in partnership with Admissions leadership to ensure adherence to policy and Program Integrity Rules in all admission interactions
- Partnered with various departments including Legal Accreditation & Licensing and Corporate Compliance to ensure policy and procedures were being followed
- Communicated potential risk to senior leadership and worked to develop mitigation solution
0-5 years of experience
Supervised over 150 inspection stations
- Performed audits for private security and concealed handgun companies
- Prepared reports, issue citations, and warnings
- Conducted training on policies, rules and regulations when required
- Processed, investigated and resolved complaints and/or inquiries regarding business activities
0-5 years of experience
Perform agreed upon procedure engagements examining books and records of multiple companies
signatory to a specific collective bargaining agreement
- Analyze tax returns, payroll records, general ledger, subcontracting agreements, and any other business
- Prepare a detailed agreed upon procedure report to present findings, and prepare the report for possible
- Led engagement teams to perform large engagements, and trained new employees on specific clients
0-5 years of experience
- Performed risk assessments and determined level of risk
- Monitor compliance with laws, regulations, and policies
- Conducted audits of high risk areas of hospital
- Prepared reports with recommendations for procedures or process improvements
- Re-educated staff on regulations and issues identified in the audit
6-10 years of experience
Communicated Medicare regulatory requirements to operational areas and conducted follow up to assure implementation. Obtained clarification and guidance from CMS as appropriate. Identified potential compliance issues, assisted with investigation and resolution, escalated issues to management when appropriate. Conducted monitoring to measure compliance with CMS regulations and guidance, communicated findings to impacted business areas and completed follow up to assure resolution of the identified issues.
- Completed coding and billing audits daily, weekly and monthly based on area of focus. Provided education to Medical Staff via Power Point, email blasts, group and/or one-on-one settings.
- Completed ICD 10 training to ensure smooth implementation for October 2014.
- Assigned daily admissions, certified and recertified the appropriate CPC codes for accurate billing and patient status reporting.
- Provided monthly orientation to new employees for Risk Management, Compliance and Billing departments.
0-5 years of experience
- Led targeted evaluations of applicants’ and service providers’ compliance for participation in the $3.9 billion annually funded Schools and Libraries E-rate Program, per the established SLD procedures, with strong focus on the eligibility review of RFPs, contracts and price quotes.
- Supported teams in completing special projects including the state discount revalidation project and assisting in training of temporary employees, therefore assuring that customer expectations were met and exceeded, and ensuring retention of the SLD contract.
- Delivered customer service excellence to applicants by understanding program requirements and assisting in resolutions. Received several commendations and “thank you” letters from customers for high levels of customer satisfaction, which helped in solidifying employer’s customer retention.
- Recognized for consistently performing in the top 33% of production, achieving top 5 or better overall error rate of less than 0.75%, while handling between 600-800 applications annually.
- Achieved over $60 million in funding disbursement to schools and libraries ahead of customers’ expectations and company goal/deadline.
10+ years of experience
Planned pension audit engagements by researching prior audits and collective bargaining agreements (CBA), discussing Employer work environment, letter files, and possible audit risks with Audit Supervisor.
- Set up audit parameters in Oracle-based Audit Contribution System (ACS) software based on CBA, payroll frequencies, and other audit factors.
- Used Excel pivots and lookups to ensure complete and proper pension contributions have been remitted; billed for missed contributions and credited overpayments in ACS.
- Discussed findings with employer contacts and/or top employer management.
- Documented disagreements and resolved disputes with the participation of both the Local Union and the Employer.
- Performed other functions as required by the Audit Supervisor or Manager.
- Helped train new audit staff.
10+ years of experience
Audit hazardous material shipments to verify all applicable regulations from the following agencies: [company name] (UPS), Department of Transportation, or International Civil Aviation Organization were met by the shipper before transport through the UPS system.
- Verify hazardous information was entered into the Hazardous Materials Management System accurately by shipper. If not, correct errors.
- Audit high value (HV) packages (packages insured from $5,000 to $50,000) for correct packaging and labeling.
- Enter information regarding the HV package into the High Risk Control System (HRCS), control the progress of the package through the center of operation, and update the Outbound Information of the package in HRCS.
- Collaborate with management to process HV packages and problem-solve hazardous material discrepancies.
- Selected from 110 employees by management for current position.
- Top achiever on tests for the certification of Auditor.
- Supervise employees for special work assignments.
0-5 years of experience
Audit loan files for compliance-related exceptions and determining possible cures/potential risk associated with the loan
- Perform compliance audits on closed mortgage loans to ensure loan files were underwritten in compliance with bank and investor guidelines
- Analyze risks and compensating factors and develop solutions for the deficiencies or issues identified to enable proper loan delivery
- Review documents such as: Note, Hud-1, Loan Approval, CLUES, CLOUT, 1008, 1003, for accuracy
- Re-calculate ratio’s to ensure the closed loans were in compliance with investor guidelines when approved
0-5 years of experience
- Reviewed, analyzed, and implemented processes to promote customer satisfaction through work order reviews quality assurance calls improving production times over 80%. Provided coaching and feedback weekly to promote quality improvement. Identified training needs and recommended solutions to enhance departmental efficiency. Prepared and distributed quality reports used by sales management team decreasing overall order entry errors ~ 50%.
- Identified and recommended training for CCRs when implementing processes and procedures. Reviewed work orders using system-designated method. As lead auditor, provided direction and assistance to quality team manager.
- Managed all communication between the Sales office management, the Manufacturing plant management and company President regarding material consumption and delivery date availability. Approved or denied rush order requests and provided all sales agents with material and date updates daily based on this communication.
- System updates on the POS system. Created and completed daily and weekly reports for sales, waiting orders, and error percentages utilizing Microsoft Excel formulas with an accuracy rate of ~ 95%
0-5 years of experience
Assisted with the implementation of policies, procedures and practices as they relate to Quality System Management, Good Tissue Practices, cGMP (current good manufacturing practices), QSR (Quality System Regulations), ISO 9001, ISO 13485, ISO 14971, AATB Standards for Tissue Banking (13th ed.), and other applicable Industry Standards.
- Performed compliance audits for the Internal Quality Audit Program (Lead Auditor), Supplier Audit Program and Laboratory Compliance Program to assure compliance to the established quality system, industry standards and regulatory requirements. Areas of routine review included: manufacturing, clinical research, complaint handling, donor quality assurance, tissue processing, chemistry and microbiology laboratories, sterility assurance, etc.
- Provided assistance, as requested, with any outside compliance assessments, both on-site and through the completion of Surveys, i.e., FDA, ISO, AATB, Recovery Partners, State Agencies and International Regulators.
- Reviewed and reported on audit findings; apprised management of audit findings and initiated discussion with the appropriate personnel to resolve issues.
- Performed effectiveness assessments as part of the CAPA (Corrective and Preventative Action) program to insure compliance to the established quality management system and any regulatory requirements; ensured comprehensive procedures were in place, and appropriate root cause and corrective actions were identified.
- Coordinator of laboratory compliance for approved tissue donation partners.
- Served as scribe and SME (subject matter expert) for numerous FDA audits.
0-5 years of experience
Gathered and analyzed data on Firm processes and procedures and created reports from that data on a monthly basis to ensure that federal regulations were met
- Assessed the remediation taken by each department per the monthly reports created.
- Interacted with clients and regulatory agencies in order to meet and fulfill their needs and requests.
- Created instructional texts on the company’s processes and procedure to ensure future stability of the company.
- Conducted trainings on firm processes and procedures applicable to position.
0-5 years of experience
Primarily responsible for the administration and management of multiple assigned Compliance Audits supporting multiple functional areas
- Identifies areas of risk and regulatory guidance gaps within functional internal process flows and procedures in conjunction with exhaustive research of regulatory guidance
- Measures associated identified risks and develops solutions as recommended Corrective Action Plans as part of the Compliance Audit reporting procedure
- Interfaces with Functional Area representatives to create and maintain Corrective Action Plans with monitoring of progress
- Maintains Compliance Audit database in SharePoint for assigned Compliance Audits to report progress and store relevant compliance documentation
6-10 years of experience
Solely responsible for managing client account (trade union) for the purpose of conducting payroll compliance audits from among signatory contractors
- Have overseen completion of close to 500 audits, generating over $4,000,000 of potential revenue for client account
- Successful at keeping account as part of company portfolio by overcoming various obstacles
- Managed two employees at all times, both in office and in field on audit visits
- Ability to adapt to and recognize the many various personalities on field audits for the purpose of achieving the best possible results throughout the audit process all the way to completion
- Maintain various status reports for both employer and client
- Extensive use of Microsoft Excel spreadsheets
6-10 years of experience
Conduct compliance audits, fore cause, and partnership due diligence evaluations of third party manufacturers, active pharmaceutical ingredient suppliers, medical device and contract service providers.
- Quality Assurance Supply Auditor: Managed over 400 suppliers which supplied products to over 10 global manufacturing operations. Conducted over 100 supplier audits. Identified critical supply chain issues which prevented major recall of finished products. Resolved Drug Master File compliance issues with contract API manufacturer.
- Supplier Improvement Plans: Developed alliances with suppliers to resolve critical supplier quality issues. Resolved critical supplier issues without any interruption to production.
- Global Operating Procedure for Conducting Supplier Audits: Developed global operating procedure for conducting supplier audits. Conducted auditor training seminars and trained individual auditors. Published internal Regulation Change Announcements for global auditors.
- Quality and Technical Agreements: Developed the global quality agreement templates for API, Excipient, and Contract Laboratories. Implemented over 20 supplier quality agreements.
- Avoided Critical Regulatory Observation: Identified major compliance gap between the Third Party Manufacturer and the product Drug Master File. Managed Abbott team comprised of Regulatory, Stability Services, Technical Services that resolved compliance gap.
0-5 years of experience
- Conducted internal audits in accordance with the Board approved audit work plans, providing formal
- Investigated potential non-compliance and/or fraudulent activities reporting to regulatory bodies as needed.
- Served as a compliance resource to the organization to ensure all regulatory requirements are met in accordance with CMS and OIR requirements.
- Served as the HIPAA Privacy Officer, investigated incidents of disclosures, maintained policies and notice of privacy practices, documented accounting of disclosures, issued member breach notifications,
0-5 years of experience
- Conducted personal independence audits of partners to ensure compliance with SEC and firm policies and regulations
- Audited the personal financial records of the firm’s partners and prospective partners to identify potential legal conflicts of interest
- Conducted background/reference checks on prospective broker/correspondent applications through various tools.
- Analyzed background information and determined false positives
- Prepared recommendation memos for Senior Management approval, capturing the pertinent data for analysis.
- Conducted personal independence audits such as prior to employment, promotion to manager or admission to the partnership, and entry in the Chain of Command to comply with the firms personal independence policies and procedures
0-5 years of experience
- Designed, planed, and performed audits in SAP environment.
- Validate SAP configuration and GL mapping in the areas of Financial Accounting and Reporting, Procurement, Accounts Payable, Revenue, Cash Management, etc. and evaluate sensitive access.
- Identify key controls and discuss implementation and compliance with the business/process owner.
- Developed business narratives to document key controls identified and underlying processes to maintain functional and effective internal control system.
- Provide recommendation to process owners to advance efficiency and effectiveness, cost saving, promote effective communication, appropriate authorization, segregation of duties, verifications and reconciliations, etc.
- Work with company’s external auditors.
0-5 years of experience
- Responsible for identifying and implementing processes and procedures for financial and operational controls. Implemented new controls, process narratives, developed test plans, and test of controls
- Prepared audit reports and presented findings and recommendations to management
- Managed/maintained internal control matrices, testing results, and audit findings
- Worked directly with Loss Prevention in identifying and developing loss control improvement projects and initiatives
6-10 years of experience
Develops and recommends auditing tools and standards that will be used during compliance audits.
- Conducts Provider Billing Audits for Network Providers in accordance with Audit Billing procedures.
- Conduct Compliance Audits in accordance with Compliance Work Plan.
- Review claims Rejections and audit claim review process to identify areas of Provider non-compliance in accordance with Compliance Work Plan.
- Perform sensitive and complex investigations into allegations of provider billing fraud under the direction of the Compliance officer and/or legal counsel.
- Perform internal compliance investigations and audits throughout the health plan and provider network including compiling detailed reports with the recommendations to the Compliance officer and Management.
- Perform interviews with all key personnel involved with the investigation to verify compliance with established policies and procedures and applicable regulations
- Prepare clear and well-organized audit work papers that appropriately document the work performed; writing clear and meaningful audit comments and actionable recommendations.
0-5 years of experience
Responsible for the coordination and execution of all internal audit and risk management consulting activity related to the Medicare Gv01 functionality with specialty areas regarding the CMS Chapter 13 regulation for the Medicare Managed Care Process. Serve as the Team Lead in analyzing the productivity and performance of the financial, business process and information systems audits assessing the risk, effectiveness and efficiency of the business controls to include financial information and compliance with laws and regulations.
- Manage and oversee audit and risk management activities in accordance with Centers for Medicare and Medicaid Chapter 13 auditing standards and the Internal/External Audit Policies and procedures.
- Develop a routine audit plan using an appropriate risk-based methodology and Best Practices including any risk or control concerns identified by management and the client’s Audit Committee. Submit adopted audit plan to Senior Management.
- Participate in the planning, design, development and implementation of major business processes and systems implementation to determine whether adequate controls are incorporated in the systems processes. Ensured thorough testing is performed at appropriate stages, documentation is complete and accurate, and the needs of the client are met.
- Generate statistical models reports and dash boards analyzing non-compliant audit trends used to develop risk assessments and corrective action plans aimed at leading MSO Service Team Sites into compliance with Centers for Medicare and Medicaid Services regulations and the Medicare Five Star rating requirements.
- As part of the Medicare Fraud, Waste and Abuse investigative process initiate Section A investigations involving potential contractual representation of licensed selling agents of Medicare Insurance plans.
0-5 years of experience
- Assessed effectiveness of Information Technology processes and controls including SOX controls at domestic and international locations
- Identified the most effective and efficient approaches to mitigate IT risks and continually evaluate the effectiveness of processes in place
- Led and executed SOX compliance procedures, including review of internal control documentation, testing of key general computer controls and business controls
- Performed some non-SOX compliance audit initiatives, including HCP (HealthCare Professional) Payments
- Worked closely with co-source provider to complete areas under review
- Provided assistance to external auditor in their annual SOX control assessment
- Provided input to IT management at Corporate and divisions on IT related internal control design as needed
0-5 years of experience
Audited internal departments and procedures to comply with SEC regulations (25-30 tests annually).
- Documented and validated the operating effectiveness of each department’s internal control system.
- Create new tests, or portions of tests, as procedures evolve.
- Effectively communicated with the department managers on concerns arising from tests.
- Prepared and implemented audit plan for the fiscal year.
- Present monthly report to the risk committee.
- Organize compliance and information security training.
- Perform daily monitoring activities and resolve any issues related to security trading.
- Create and implement new policies to comply with SEC regulation.
- Assist in the preparation of SEC document request letters.
0-5 years of experience
Research, reconcile and document discrepancies to identify corrective action required and report findings.
- Completed business process management audits on company’s internal controls and application processes.
- Worked with local government officials to ensure the integrity and completeness of the recovery financial records in accordance with federal and state guidelines, and generally accepted accounting principles (GAAP).
- Assisted in preparation of project budgets, budget tracking, project procurement documentation, and budget variance reporting.
6-10 years of experience
Managed the regulatory and compliance activities of over 200 agents in 4 different states.
- Conducted compliance audits on individual agencies, working to identify possible errors and omissions, state regulation breakdowns, and opportunities of improvement.
- Lead training sessions in district sales meetings, agency staff meetings, and team presentations on state laws, corporate procedure, and federal regulations.
- Worked with corporate leadership to identify and correct policies in conflict with state and federal guidelines.
0-5 years of experience
- Ensure compliance with Medicaid & Department of Behavioral Health & Developmental Services regulations by examining and analyzing records, reports, operating practices, and documentation; recommending opportunities to strengthen the internal control structure.
- Conduct research in order to determine billing and reimbursement compliance with relevant Medicaid regulations (Includes reviewing for fraudulent billing).
- Research and resolve any findings identified during audits conducted by external Medicaid Auditors.
- Communicates audit progress and findings by preparing reports; providing information in meetings.
0-5 years of experience
Perform and schedule routine examinations of employer accounting records to verify compensation pertaining to hours worked or guaranteed of employees performing collective bargaining union work on films, television shows, commercials and music videos.
- Identify contribution variances by comparing reported contributions to contributions due based on guarantees pursuant to job classifications covered by applicable contracts and agreements.
- Research applicable union wage scale agreements, while prioritizing work and scheduling of upwards of 20+ active audits at any given time.
- Prepare sample audit populations using judgmental and random sampling techniques.
0-5 years of experience
Document and communicate information related to employee pre-screening requirements (such as drug testing, background checks and required documents) as defined in customer service agreements.
- Perform audits weekly to review documentation for each newly hired consultant to ensure compliance with contractual requirements.
- Communicate areas of non-compliance and escalate accordingly.
- Prepare documentation for Customer initiated audits and provide to the Customer timely and accurately.
- Propose continual improvements to processes and policies based on audit results.
- Perform account maintenance, to include updating compliance requirements within assigned accounts and communicating any changes.
- Provide training and education to field offices based on audit results. Coordinate best practices to improve in problematic areas and work with the field offices to impact these areas.
0-5 years of experience
Perform audit interviews in order to verify compliance with internal policies and procedures as well as external regulations
- Report on issues of non-conformances as well as highlight areas of good practice, in order to assistance in encouragement and enhancement company-wide
- Identify compliance issues by meeting with students to complete student surveys as a means to ensure that students and prospective students are being provided superior customer service
- Compile and prepare audit findings
- Review audit findings and provide feedback to employees in other departments
- Meet regularly with other members of the Compliance Department
0-5 years of experience
Monitors and test internal controls and policies and procedures to ensure compliance with regulatory requirements and business procedures.
- Identifies appropriate controls and key business risks and evaluates the adequacy of the controls designed to manage those risks.
- Provides written reports, summary of findings and recommendations and works with Senior Management to address identified deficiencies.
- Assists with the monitoring of all regulatory changes, ensuring communication of new requirements and assisting the business units in creating/revising policy and processes to meet new requirements.
- Creates planning memos and work programs to ensure compliance with the regulation at the focus of the audit.
- Prepares work papers documenting the conclusions of each audit objective.
- Supports Compliance Directors in the performance of annual risk-assessments with regards to various laws and regulations.
- Serves as the liaison between Internal Audit and the audited business units to identify and address compliance concerns as new initiatives are undertaken, or new regulations are issued, or changes are made to business processes.
0-5 years of experience
Inbound service calls from members and/or providers with questions related to, but not limited to, health benefits, eligibility status/issues, and claims inquiries, requests for member materials, primary care physician changes, prescription coverage, prescription benefits, Organization determination, and Id cards.
- Ensures compliance with regulations and controls by examining and analyzing records, reports, operating practices, and documentation; recommending opportunities to strengthen the internal control structure
- Audit Appeals & Grievances completed by agents
- Support Insurance and/or Prescription Drug Plans
- Educate customers on plans and processes Qualify customers for community meetings and in-home appointments
- Ensures proactive customer with the highest degree of courtesy and telephone etiquette
- Performs other duties and tasks as assigned
0-5 years of experience
Conduct financial and operational audits of four hospitals and corporate operations of the company.
- Plan, compile, analyze and summarize audit information and data.
- Review audit working papers for content, completeness and compliance with department standards.
- Evaluate results and findings of the audit and make recommendations to CEO and/or CFO of each hospital upon completion of assignments.
- Perform in-depth review of physician contracts/arrangements for four hospitals associated with Stark Law and anti-kickback statutes.
- Perform SOX review/testing
- Perform special audit projects upon request of management.
0-5 years of experience
Prepared and modified Cost Accounting Standards (CAS) Disclosure Statements based on Contract Clauses
- Conducted compliance audits with emphasis on the new contract business practices, supporting the Federal Acquisition Regulation (FAR) clauses specific to labor and travel guidelines
- Responsible for interviewing 100% of the company’s employee population to ensure compliance with the labor and travel guidelines
- Responsible for documenting audit findings and escalating occurrences of noncompliance to senior management
0-5 years of experience
Report directly to the senior director, compliance. Provide support to pharmaceutical Territory Business Managers, Regional Business Directors and compliance analyst
- Review expense reports for accuracy to be compliant with company policy, procedures, and adhere to the federal government rules and regulations of the Physician Financial Transparency (Sunshine Act)
- Collect and track payments; transfer and ownership information submitted to the Centers for Medicare & Medicaid Services
- Responsible for auditing and processing Travel & Entertainment through PeopleSoft system
- Utilize MS Excel to create charts, graphs, spread sheets. Use MS Word and PowerPoint to create documents
- Created the compliance training manual for existing and new hire employees
6-10 years of experience
Handles calls from internal and external customers
- Works closely with Sales on several key accounts providing analysis of customer disputes
- Assists customers and Trade and Marketing in maintaining rate integrity
- Participated in the development of the CRC Mail system
- Assisted management with special projects
- Worked on tariff issues with Sales and Trade Analysts
- Position requires strong data entry skills
0-5 years of experience
Site lead compliance auditor responsibilities, which includes: preparing audit plan, scheduling and holding the opening meeting, coordinating/conducting the audit, review of audit findings with affected management, publishing notes, preparing the audit report, assigning observations to the appropriate quality system, assign observation rating, hold the closing meeting, publish final report and enter audit, observations and CAPAs into the site exception reporting tracking system (Trackwise).
- Participation on external audit team support
- Responsible for the preparation of FDA Status Updates to 483 responses and other communications
- Review and approval of site SOPs, batch records, and specifications
- Participation on the Validation Review Board as the Compliance approver
0-5 years of experience
Audit information technology (IT), platforms, and operating procedures in accordance with established standards for efficiency, accuracy, security and risk mitigation.
- Evaluate IT infrastructure in terms of risk to the organization and establish controls to mitigate loss. Plan audits, analyze audit results and test auditing programs.
- Determine and recommend improvements to current risk management controls.
- Work with security representatives, system administrators and Information Assurance professionals in the identification, communication and escalation of security-relevant events in an effort to prevent unauthorized intrusion
- Revise controls for new or modified computer applications to prevent data loss, and to ensure discovery of errors.
- Perform reviews of Operating Systems and ERP Platforms audit logs for SOX 404 Compliance Guidelines
0-5 years of experience
Worked to develop, implement and conduct compliance testing and reporting related to the Affordable Care Act for the Center of Medicare and Medicaid Services (CMS).
- Develop, refine, and support the development of key project deliverables used to build the infrastructure for Compliance Reviews related to the Affordable Care Act.
- Conduct on-site and desk Compliance Reviews of Patient Protections and Affordable Care Act Exchanges and Issuers of Qualified Health Plans.
- Evaluate compliance with Federal legislative and regulatory requirements.
- Create reports providing findings, conclusions, and recommendations to CMS and Qualified Health Plan management.
- Provides guidance to corporate entities to strengthen their organizational systems.
10+ years of experience
Review of Physician documentation in order to assign the correct ICD-9-CM codes and level of Evaluation and Management codes, according to the 1995 and 1997 documentation guidelines as they relate to the various specialties
- QA of defined audit data to identify critical root cause errors by quantity, financial impact, and complexity of issue and develop an issue list
- Present results to Service Chief and Service members; collaborate with physicians and administration to address and resolve issues
- Initiate and implement monitoring plans based on root cause analysis
- Retrospective review and analysis of medical records to interpret documentation and identify all diagnosis and procedures performed
- Meet with and train new physicians on documentation guidelines
- Respond to inquiries relating to coding, compliance and medical documentation concerns from physicians, administration staff, and third parties.
- Performed all duties in a highly organized, efficient and professional manner
0-5 years of experience
- Traveled to employer’s offices or their representative’s office interpreting different state, and federal tax documents including:
- Analyzed parts of federal tax returns for companies, corporations and partnerships
- Analyzed individual tax returns for sole proprietorships
- Made sure employers are following modern accounting practices, and following their collective bargaining agreement
- Followed rigorous compliance audit procedures including the tedious review process of a company’s A/P books, Bank reconciliation statements, and payroll forms and documents
- Found discrepancies for clients that sometimes accumulated to greater than $1MM
0-5 years of experience
Works with the director of corporate compliance to identify and execute compliance audit programs
- Identifies and resolves a variety of regulatory issues and assists with development and implementation
- Contributes to the design improvements of compliance program initiatives; provides policy interpretations
- Reviews and analyzes responses to audit observations and interviews and facilitates corrective action plans
- Evaluates processes and performance through audits for scalability effectiveness, efficiency, and risk mitigation