DRG Clinical (RN) Validation Auditor auditing inpatient medical records to ensure accuracy in billing and reimbursement. Specializing in Diagnosis Related Group (DRG) paid claims with a focus on clinical documentation integrity.
About the role
- Lead Auditor for the San Francisco Federal Reserve Bank conducting internal audits for large scale operations. Supervising audit team members and ensuring effectiveness of controls and compliance.
Responsibilities
- Supervise and review moderate to moderately high-risk audit work performed by audit team members in accordance with established internal and external policies and audit standards
- With guidance, evaluate audit team members’ performance after each assignment
- With limited supervision, guide the work of auditors to ensure quality expectations
- Define appropriate risk-based audit scope and objectives for District focused audits, establish and commit to assignment time frames and budgets, develop new or revise existing audit programs
- Execute the approved audit program in accordance with established policies and standards under general supervision with a greater degree of independence
- Identify, assess, and challenge the impact of audit exceptions, make appropriate recommendations and present clear and convincing explanations of the issues with audit management and operating personnel
- Prepare written audit reports, requiring reasonable edits from internal reviews to business management at the conclusion of audit reviews
- Appraise the adequacy of corrective action taken to address previously reported audit findings or findings identified by other assurance providers.
- Review follow-up work performed by other auditors
- Obtain and maintain a detailed knowledge base and awareness of activities in moderate to moderately high-risk areas of assigned liaison coverage, review and analyze pertinent data, and learn how to assess the impact of changes
- Develop or maintain audit programs and perform risk assessments for assigned areas of liaison coverage
Requirements
- Knowledge and experience normally acquired through a Bachelor's degree
- Certified Internal Auditor (CIA) or Certified Information Systems Auditor (CISA) required within 24 months of placement in role
- Five or more years of experience as an internal auditor, preferably in an audit project lead capacity (i.e., Auditor-in-Charge, Lead Auditor)
- Proficient audit specific communication skills including strong targeted verbal and writing skills in team-internal and audit stakeholder related interactions
- Ability to resolve conflicts in more challenging or complex situations
- Strong understanding of general audit applications, ability to perform more complex data analytics, and good knowledge of general IT controls
- Proficient knowledge of Microsoft Office
- Sound knowledge of risk management, compliance, and data related frameworks
- Proficient understanding of concepts of risk and control and ability to challenge others judgment when assessing these
- Good understanding of root cause analysis and leading related discussions
- Proficient in assessing and distinguishing between control design, operational effectiveness, and outcome
- Full understanding of the Institute of Internal Auditor's International Professional Practices Framework (IPPF); and the Committee on Sponsoring Organizations (COSO) internal control and Enterprise Risk Management (ERM) risk assessment frameworks
- Strong presentation, facilitation, and project management skills
- Ability to travel approximately 15% of the time
- Must be a US Citizen or Green Card holder with the intent to become a US Citizen.
Benefits
- Medical
- Dental
- Vision
- Pre-tax Flexible Spending Account
- Backup Child Care Program
- Pre-Tax Day Care Flexible Spending Account
- Paid Family Care Leave
- Vacation Days
- Sick Days
- Paid Holidays
- Pet Insurance
- Matching 401(k)
- Retirement/Pension
Job title
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Experience level
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