Director of Internal Audits

A healthcare organization is seeking an experienced Director of Internal Audits to provide strategic oversight of the internal audit function and ensure strong governance, risk management, and internal control practices across the organization. This role is responsible for developing and executing a comprehensive, risk-based internal audit workplan, with a strong emphasis on regulatory compliance, billing integrity, and healthcare coding standards.

This position requires a senior leader with deep healthcare audit experience, strong regulatory knowledge, and the ability to collaborate across clinical, compliance, and executive teams.

The Director of Internal Audits leads the organization’s internal audit program, providing independent and objective assessments of operational, financial, and regulatory risks. This role owns the Internal Audit Work Plan, oversees audit execution and reporting, partners closely with Compliance and executive leadership, and ensures preparedness for external regulatory reviews.

Audit Strategy & Governance

• Own and maintain the Internal Audit Work Plan, including audit scope, frequency, and sampling methodology
  

• Ensure audits are performed and documented in accordance with internal standards and regulatory expectations
  

• Design and execute annual and long-term audit plans aligned with organizational risk
  

Regulatory & Compliance Audits

• Plan and oversee audits reviewed by regulatory bodies such as OIG and OMIG
  

• Partner with Compliance Officers to support Compliance Work Plans and shared audit initiatives
  

• Assess adherence to federal and state healthcare regulations, CMS guidelines, and billing requirements
  

Healthcare Coding & Documentation Oversight

• Oversee audits of medical record documentation to identify undercoding and overcoding
  

• Review audit findings and communicate results to physicians for education and compliance awareness
  

• Research and respond to inquiries related to compliance, coding issues, denials, and billable services
  

Leadership & Collaboration

• Serve as the primary liaison between Internal Audit, executive leadership, and department heads
  

• Prepare and present audit reports to Executive Management, Compliance, and Finance leadership
  

• Lead, mentor, and develop internal audit staff; promote accountability and continuous improvement
  

• Collaborate across departments including clinical operations, informatics, managed care, and billing
  

Operational Excellence

• Conduct risk assessments and support corrective action planning
  

• Promote ethical practices, transparency, and strong internal controls
  

• Stay current on regulatory, coding, and compliance changes through ongoing education
  

• Bachelor’s degree in Business Administration, Healthcare Administration, or related field
  

• Minimum 5–7 years of auditing experience, preferably in a healthcare environment
  

• 10+ years of supervisory or leadership experience
  

• Strong knowledge of CPT codes, ICD-9/10 codes, and CMS guidelines
  

• Understanding of federal and state healthcare compliance regulations
  

• Experience auditing medical documentation, billing, and coding practices
  

• Proven ability to lead and manage audit teams
  

• Strong analytical, investigative, and problem-solving skills
  

• Excellent written and verbal communication skills
  

• Ability to manage multiple priorities in a fast-paced environment
  

• High attention to detail with strict confidentiality standards
  

• Proficiency with Microsoft Office and audit documentation tools
  

• Strong project management and cross-functional collaboration skills