DIRECTOR COMPLIANCE AUDIT Resume Example Company Name

DIRECTOR COMPLIANCE AUDIT

Executive Profile

Risk Assessment | Efficiency & Effectiveness | Performance Improvement Policy & Procedures Creation & Training | Staff Mentoring & Development Expertise in implementing thriving Corporate Compliance Programs with a track record of success for establishing effectiveness. High-level reporting and exposure to Board and Senior Leadership. Seasoned Internal Auditor with a flair for understanding diverse operations and making complex decisions that require professional and objective judgment. Multi-Industry Exposure Audit and compliance experience spanning 25 years working in healthcare, non-profit, government, the retail and private sectors.

Professional Experience

01/2015 to Current

DIRECTOR COMPLIANCE AUDITCompany Name － City, State

Multi-specialty physician practice and partner of EmblemHealth, consisting of 450 practitioners providing care at 37 medical offices located in New York City and Long Island with 2,500 union and non-union employees.
Provides leadership of billing and coding and operational audits.
Reports directly to the VP Compliance; Staff: 5 Establishes prospective audit process to examine encounters completed by all physician and non-physician practitioners, applying an 80 percent audit passing threshold.
Introduced predictive analytics using a comprehensive solution that improves risk mitigation and advances the identification of coding outliers of physicians and non-physicians.
Conducts risk assessments to mitigate non-compliance and fraud with coding and documentation, internal process and policy operations.
Produces key performance indicators for measuring monthly audit productivity.
Uses templates and reporting formats effectively communicating audit findings.

01/2001 to 01/2015

VillageCareCity, State

215M continuing care organization with skilled nursing, short term-rehabilitation, assisted living, home care, case management, adult day care services and managed care plan with 1,200 union and non-union employees.

01/1997 to 01/2001

CORPORATE COMPLIANCE OFFICER, CHIEF INTERNAL AUDITOR AND PRIVACY OFFICERCompany Name － City, State

Lead day to day Corporate Compliance Program and Internal Audit and Privacy functions.
Reported directly to the President/CEO and Board's Audit Committee; managed $350k budget; Staff: 3 Achieved national certification for Compliance Program by effectively implementing the elements.
Created policies and procedures and operationalized compliance program and HIPAA requirements.
Collaborated with Chief Information Officer on information security and potential breach matters.
Increased education and awareness of Compliance and achieved 100% completion of annual mandatory training.
Created internal incident/complaint management tool that improved the capture of reported allegations of fraud, compliance and quality related issues and initiated investigation within 24 hours.
Facilitated annual conflict of interest process and tracked 100% of the disclosures and attestations submitted by management and the Board.
Lead annual risk assessment process and developed annual compliance/audit workplans.
100M annual sales at world renowned, privately-held retailer with stores and warehouse distribution centers located in New York City, New Jersey and Long Island with 3,000 union and non-union employees.

01/1988 to 01/1997

INTERNAL AUDIT MANAGERCompany Name － City, State

Lead internal audit department and conducted tests of compliance with internal policies and procedures and inventory security controls.
Worked with the Loss Prevention and Fraud departments and conducted investigations of reported and observed thefts (e.g.
cash, credit cards, gift certificates, merchandise) and identified fraud schemes at point of sale.
Audited daily cash counts and credit sales for internal banking operation and verified daily safe reconciliations.
Reported directly to the Chief Operating Officer and the Director of Loss Prevention.
Staff: 3.
Created numerous audit tests to verify standard operating procedure compliance and test internal controls over cash and inventory.
Conducted financial/operational audits of corporate operations consisting of Accounts Payable, Payroll, Human Resources, Buying Offices, Freight and Accounts Receivable procedures and controls.
Third highest elected official in NYC, who serves as Chief Financial Officer and Chief Auditor and is legally authorized to examine the accounts and books of City agencies including the Office of the Mayor with 14 Bureaus and more than 700 employees.
AUDITOR-IN-CHARGE - Bureau of Management Audit Conducted operations and performance audits to provide comprehensive oversight of the City's budget and fiscal condition.
Reported directly to Bureau Division's Audit Manager/Supervisor.
Staff: 2.
Conducted audits in accordance with Generally Accepted Auditing Standards ("YellowBook").
Assisted in annual risk assessment for developing division's audit project plan.
Produced workpapers, audit programs and written materials to support audit objectives.

Education

Bachelor of Business Administration: Public Relations/Advertising and international Law Firm Finance and AccountingBaruch College (C.U.N.Y.) － City, StatePublic Relations/Advertising and international Law Firm Finance and Accounting

Holds CHC and CCP HealthCare Compliance Certifications

Professional Affiliations

Pending CIA/CRMA Internal Audit and Risk Certifications Health Care Compliance Association (HCCA)Institute of Internal Auditors (IIA)Association of Healthcare Internal Auditors (AHIA)Health Ethics Trust, division of the Council of Ethical Organizations (HET)

Skills

Accounts Payable, Accounts Receivable, assisted living, Auditing, banking, billing, budget, case management, credit, documentation, Financial, home care, Human Resources, information security, Internal Audit, inventory, leadership, Loss Prevention, Director, materials, Office, nursing, Payroll, policies, coding, quality, rehabilitation, reporting, risk assessment, sales, Supervisor, written

Resume Overview

School Attended

Baruch College (C.U.N.Y.)

Job Titles Held:

DIRECTOR COMPLIANCE AUDIT
VillageCare
CORPORATE COMPLIANCE OFFICER, CHIEF INTERNAL AUDITOR AND PRIVACY OFFICER
INTERNAL AUDIT MANAGER

Degrees

Bachelor of Business Administration : Public Relations/Advertising and international Law Firm Finance and Accounting
Holds CHC and CCP HealthCare Compliance Certifications

DIRECTOR COMPLIANCE AUDIT Resume Example

Resume Score: 90%

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