In the modern-day and age, it can be seen that there is a need to ensure that all the relevant tasks and objectives within the HIPAA Compliance Audit are undertaken so that they are able to get the best possible results.
As a matter of fact, it can be seen that HIPAA Compliance Audit is undertaken in order to gauge the extent to which an organization has safeguards and preventive measures in place that can mitigate the underlying risk of possible financial setbacks, as a result of the security breach.
Therefore, companies are required to follow the set blueprint for their own benefit.
HIPAA Compliance Auditor is therefore required to enact bearing in mind all the set rules and policies that have been put forth by the HIPAA so that they are able to act in accordance with the set laws and regulations.
It requires the auditor to prepare a checklist so that they have a clear-cut idea regarding what needs to be achieved, and what can be fulfilled in order to get a clean sheet when it comes to safety protocols within the organization.
HIPAA Compliance Auditor:
As mentioned earlier, it can be seen that HIPAA caters to ensuring that there is proper compliance relating to the extent to which everyone is on board in terms of employees, and the fact that they have proper awareness regarding what they need to do in this regard.
The policy implementation is perhaps the most important dynamic in this regard, because of the fact that it calls for an internal audit to be taken place in order to draft an Internal Remediation Plan.
The underlying principle, in this case, is primarily the reasoning that there is an underlying infrastructure that can somewhat guarantee the extent to which the organization complies with HIPAA.
This tends to be one of the most predominant roles of HIPAA Compliance Auditor.
Additionally, the compliance auditor is also supposed to ensure that the key areas of the HIPAA are inculcated into the overall operations and security protocols within the organization.
This includes areas of administration, physical security, as well as technical security. These three key areas have been identified by HIPAA because of the tantamount importance they hold in framing a secure culture in the respective organization, alongside a mitigated risk of any possible security breach that might prove to be detrimental for the company.
Therefore, in this regard, it is the primary duty of the auditor to ensure that all the entities have properly set stringent safeguards on grounds of physical, and technical safety.
Ensuring these parameters exist requires the auditor to have a clear idea regarding the HIPAA Privacy Rule and the common violations which might adversely impact the audit taking place.
HIPAA Compliance Auditor mainly relies on the realms of OCR working closely in line with health care providers, covered entities as well as businesses to ensure that that they are truly and closely in compliance with the HIPAA regulations, as well as HIPAA privacy and security.
These audits are mainly undertaken in order to conduct track progress on compliance, and identification of areas where due improvement is required.
This is basically a step that is undertaken in order to increase the overall security protocols within the organization at large.
Therefore, the main criteria in this regard is to ensure that stakeholder interests are protected, and hence, the HIPAA Compliance Auditor is supposed to inculcate all these steps and measures in order to extrapolate the best possible returns in terms of ensuring strict compliance on these stated protocols.
Therefore, it can be seen that HIPAA Compliance Audit is undertaken to protect the company from possible financial losses resulting from security breaches.
Additionally, failure to comply might also result in HIPAA Violations and Fines. Therefore, it is imperative that a risk assessment is undertaken on part of the organization to ensure that they are able to get the best possible results and ensure a higher degree of compliance that can possibly render the desired objectives.
The best way this can be achieved is by preparing for the Compliance Audit well in advance. This would enable the compliance auditor to be able to gather all the reasonable assurance he requires before giving a statement on the extent of HIPAA Compliance in the said organization.
Over the course of time, compliance has become a pressing cause of concern for all organizations, regardless of their status, or stature.
In this regard, it is quite important to realize the fact that there is a need to abide by the set rules and regulations, so that the stakeholder interest, at large, can be prevented.
Be it corporates, or not-for-profit organizations, it can be seen that there is a need to ensure that there is a strict measure taken to ensure that all the quality protocols are duly met so that there are no complaints, and no compromises made on service delivery related issues.
Speaking of healthcare, it can be seen that it tends to be one of the most regulated sectors in comparison to typical corporates.
This is essentially because of the reason that it involves medical assistance, and this, coupled with financial concepts of insurance makes this a relatively tricky territory.
This is because financials are relatively complex, and therefore it involves a couple of different aspects that should be inculcated to form an opinion regarding the accuracy and effectiveness of the operations, as well as financials of the healthcare provider.
Healthcare Compliance Auditor?
It is rudimentary to realize that auditing and monitoring is basically a step that is designed to act as an aid to assist the health care professionals to stay in compliance with the federal state and regulations that are designed for the betterment of these organizations.
In this regard, the healthcare compliance auditor is supposed to implement internal checks, and review the compliance program related operations.
Therefore, in this regard, the healthcare compliance auditor is supposed to monitor ongoing operations, and gather substantial evidence, that can help them verify and ensure that all the operations are being conducted within compliance that is set in the relevant area.
The main premise of the healthcare auditor in this regard it to ensure that all areas are identified prior to the audit, and then all substantive procedures are designed to inculcate all these respective areas based on which a reasonable assurance can be provided to these professionals.
In this regard, health care professionals are supposed to identify the key risk areas, assess the internal controls, design the relevant testing processes, and then validate information based on which they can formally voice their recommendations, and the possible course of action.
Healthcare Compliance Audit constitute of auditing and monitoring plans that are imperative based on operational success.
This is because of the reason that it provides much needed in-depth reviews of the compliance from inside, as well as outside of the healthcare service provider in this regard.
Furthermore, it can also be seen that these review processes ensure required procedures, policies, as well as safeguards that are in place in order to avoid risks that are associated with compliance.
In case of non-compliance related issues, it can be seen that it is imperative that these issues are dealt with so that better service protocols can be achieved in compliance with the set rules of law.
In this regard, it can be seen that there can be numerous tools that are utilized by compliance auditors, in terms of risk assessments. They want to determine the kind of risks that exist within an organization.
In the same manner, it can also be seen that auditors should also have a clear-cut idea regarding the tools that can alternatively be used.
This might include Computer Assisted Audit Techniques, which can provide a much-needed in-depth analysis of the existing billing systems, transactions, as well as internal controls.
In the same manner, the auditor should also have a proper idea regarding the existing principal risks, as well as the underlying policies within the healthcare providers system, so that they are able to comment on the reasonableness of the existing working in the business.
Therefore, there is no doubt to the fact that healthcare compliance auditor tends to be a very important tool for any organization, primarily because of the fact that it helps them get a clear insight regarding changes that are required within the organization to get better compliance-related issues and tasks.
In the same manner, it is also imperative that these auditors are able to assess the risk involved within the audit process, as well as the risk existing because of the operations that are set within the company.
This tends to be a very integral step for the organization so that maximum and optimum results can be properly achieved.
The GDPR (General Data Protection Regulation), and DPA (Data Protection Act) 2018 have been introduced in order to ensure that data protection, and consumer protection, at large is taken care of by the given organizations.
The importance of complying with these policies is gauged by the fact that there are several penalties in place in the case where organizations are unable to comply with these tasks and objectives.
Therefore, GDPR is set in order to force companies in order to get a better idea regarding data privacy and protection.
However, given the fact that these policy implications are relatively complex to implement and execute within the organization, it can be seen that there is a need to conduct an audit in order to ensure that it is properly reflected in the policy implications of the company.
Hence, in this regard, it is required that GDPR Compliance Auditor is required to have a proper roadmap that can achieve the required targets and objectives of the audit process itself.
GDPR Compliance Auditor
When conducting a GDPR Audit, the compliance auditor is supposed to cover eight major (ten overall) areas. They are mentioned below:
The Governance Principle mainly talks about personal data being utilized in accordance with six primarily principles.
They constitute of the overall ability of lawfulness, fairness, as well as transparency. Furthermore, they also talk about purpose limitation, accuracy, as well as storage limitation.
The main criterion in this regard is to ensure that they are exposed to the principle of accountability. In this regard, the auditor is supposed to ensure that there is evidence to support a culture that reflects intent on part of the governance to implement and impose the given criteria.
As far as Risk Management is concerned, it can be seen that Risk Management tends to be another important criterion that needs to be undertaken by the auditor.
It is imperative to have a proper idea regarding the underlying risks, and what needs to be done in order to mitigate the given risk threats.
The audit should also include the privacy risk pertaining to the corporate risk, and the extent with which this matter is dealt with by the policy makers.
The auditor should ensure that the organization has an appropriately staffed, funded, as well as aware about the project, and what it really entails.
Therefore, it is rudimentary to ensure that the auditors have clarity regarding the steps taken by the organization to cover the respective.
DPO (Data Protection Officer)
The auditor should also gauge the existing efficacy of the DPO Office within the company, and if the person is able to manage the existing criteria relating to GDPR Policy implications within the organization.
Roles and Responsibilities
Furthermore, the auditor is also supposed to ensure that all the moving parts within the organization have a clear-cut idea regarding the roles and responsibilities and how they have been delegated and deployed within the organization.
It shows how well the organization has grasped the GDPR Policy features, and the extent to which people have clarity regarding the roles they have.
Scope of Compliance
The scope of compliance should be easily defined, so that people are able to realize the due importance of the compliance audit, and how well there is clarity regarding the GDPR Compliance, and what needs to be done to fulfill the objectives.
For example, all the relevant databases should be identified, in addition to cross-border processing, as well as other relevant features.
The Process Analysis is conducted in order to examine the data processing principles, and existing processes that are identified as required data protection acts within the company.
This is a step within the security compliance part, and it should be observed as such by the relevant auditor.
PIMS (Personal Information Management System)
There is a wide range of documentation that goes in the company when it comes to Data Policy acts. The auditor is required to ensure that this documentation is extensively studied for any inconsistencies and irregularities.
It is important to ensure that this is something that is aligned with GDPR, in addition to the required protocols for employee training.
Therefore, there is no doubt to the fact that GDPR Compliance Audit tends to be a very important audit from perspective of companies that are highly data centric, in terms of achieving the respective KPIs, and joint ventures.
In this regard, it is also important to ensure that the compliance auditor, as well as the organization, are able to collaborate to culture an environment that is not conducive to data breaches that might eventually prove to be detrimental for the organization.
Business partnerships tend to be a regular occurrence in the modern-day business environment. This is essential because of the reason that today more and more companies synergize and collaborate in order to achieve growth in a much faster manner.
This also considerably improves their business competency and helps them to act as concerned entities in the modern day and age.
However, more often than not, business collaborations end up in disagreements and eventual revoking if business contracts. This leads to a considerable loss of time, resources, and more importantly, business opportunities for the company.
Therefore, there is no doubt to the fact that there is a tantamount importance of business contract, not only because it helps solve disagreements, but also because it acts as an aid in unprecedented business scenarios which might involve lawsuits.
Therefore, these contracts need to be drafted properly in order to ensure that both parties are protected, and there are no red flags that might expose either of the parties to a risk that might not always render the desired results.
The contract compliance auditor therefore, is appointed with the task of revisiting the company’s contracts, hereby ensuring that there is nothing questionable within these contracts.
Contract Compliance Auditor
The Contract Compliance Auditor is responsible to delve into contract management and work alongside government agencies, contract holders, and other related parties in order to gather reasonable assurance, that all the government standards and laws are duly met pertaining to contract creation, and subsequent fulfillment.
The Contract Compliance Auditor is mainly entrusted with the responsibility of ensuring that that the contracts that are drafted by the companies are in proper compliance with the set rules and regulations.
Therefore, it can be seen that they are supposed to cover aspects that can act as blueprints for efficient contract delivery.
The Contract Compliance Auditor should undertake the following features for better result outcomes.
- Achieving Maximum Value for the Contracts: This tends to be a very major objective for such audits because of the fact that there are certain terms and conditions within the contract that somewhat limits the extent to which juice can be milked from the contract. Therefore, as a Contract Compliance Auditor, this tends to be a primitive goal, to act on behalf of the auditor.
- Mitigation of Risk: Compliance Auditor is also supposed to ensure that the contract has a limited risk that can easily be identifiable. It should also be in line with the inherent risk-return tradeoff that exists within the company. Risk identification and subsequent mitigation are also something that needs to undertaken by the respective compliance auditor.
With these objectives in mind, the Contract Compliance Auditor should ideally plan the audit in accordance with the parties involved, and the ultimate goal that needs to be extrapolated as a result of the audit.
Since it is a compliance-based audit, it can be seen that there is a need to ensure that the underlying contract does not intersect the set rules and conditions in the existing state of affairs, and the legislation set out within the country.
In the same manner, it is also important to consider for the compliance auditor to establish cordial collaboration, and execution plans relating to the audit.
This is mainly about research within the organization, as well as having a proper idea regarding the broader laws that need to be followed.
Knowledge about these aspects is quite important because of the reason that it helps to identify the existing issues within the contract, and what needs to be done in order to ensure that the relevant issues are duly resolved.
Therefore, there is no doubt to the fact that contract compliance auditor tends to be rudimentary for organizations in order to safeguard themselves against penalties, frauds, and subsequent financial losses.
Hence, it can be seen that contract compliance should be taken seriously from the organization’s perspective. Even from the perspective of the auditor, it is an increasingly important task because of the responsibility involved.
Regardless of the intensity of the work that contract compliance requires, there are numerous contingencies involved within contracts that should be highlighted by the auditor.
These compliance-related issues can stem from policies within the company, as well as rules and regulations that are set out for company-related contracts by the respective government.
Hence, with these objectives and requirements in mind, contract compliance auditor is supposed to study the company, as well as potential areas of improvement that can enable companies to get better results from contracts.
With compliance-related issues increasing over the course of time, it can be seen that there is a market gap between demand and supply of compliance audit professionals.
Given the vast variety of options that people have relating to compliance audit certifications, it is fundamental to consider the different options that are available to them.
All of these certifications are certified and are specialized in terms of achieving the required Key Performance Indicators.
Compliance Auditor Certification
A compliance audit is a field that constitutes of numerous different areas that require specialized knowledge.
Risk, Governance, and Compliance (GRC) Certifications are perhaps the most in-demand area of expertise within the realm of a compliance audit.
This is essential because of the reason that this is required by almost all top roles, because it requires these auditors getting a holistic insight pertaining to existing laws and regulations, and what needs to be done in order to establish compliance with the set laws and rules.
Here’s a list of some of the common certifications that are included under compliance audit.
- Certification in Risk and Information Systems Control (CRISC) – This specific certification covers almost all fundamental areas of risk, and how it can be monitored, quantified, and subsequently controlled. This is fundamental for a number of strategic positions within the organization because of the reason that it directly impacts and influences how decisions are taken within the company.
- Certification in Governance of Enterprise IT (CGEIT) – This certification is targeted towards enabling professionals to get an idea regarding IT and the role it plays within the organization in terms of integrating business strategies as well as IT. This alignment is a significant one and requires compliance in terms of data safety and security breaches.
- HEDIS Compliance Audit – The HEDIS Compliance Audit comprises of Healthcare Effectiveness Data and Information Set. This is widely used to measure and subsequently improve health care quality. This is something that should be adopted by health care professionals, as well as governments in order to assess the extent to which they abide by the generally accepted rules and principles. The certification enables the auditor to assess the viability of the existing healthcare system, and how it can be improved over the course of time.
- IAA Award in Compliance Audit and Assurance: The main purpose of this certification is to enable professionals to understand compliance-related audits, and how it should be undertaken in order to provide the customers with reasonable assurance. It prepares professionals in terms of getting accustomed to the required process.
- Process Safety Management (PMS) – This is another course that offers individuals to get equipped with the tools that can enable them to gather resources that can help them to evaluate companies in terms of their overall compliance with the set rules and regulations.
- HACCP Audit Certification – HACCP Audit is considered as another quality inspection audit that helps professionals to evaluate companies on grounds of the extent with which they are compliant to the rules set by HACCP.
Therefore, it can be seen that there are multiple different avenues that can help individuals get the required certifications.
It is imperative that these certifications are utilized for the greater outcome, and can help auditors comment on extent of compliance.
Compliance related issues are really vital to be considered within the scope of the company, and hence, compliance audit certifications are high in demand, more so than ever.
Hence, it can be seen that Compliance Auditor requires evaluating information in order to determine compliance with the set standards. It also requires data analysis.
Hence, certifications that are specific to the nature of the respective aspects in this regard. The Compliance Auditor Certification hence tends to be one of the most crucial parts in determining the respective area where the auditor can be hired.
Given the fact that there are numerous options to choose from, and the underlying scheme of affairs relating to compliance-related matters is at an all-time increase, the demand for these certifications is justified.
However, what must be accounted for is the fact that in order to get these certifications, it is important to have a basic sense of functioning within the company, and a certain number of years as experience.
This combination is perhaps the most vital for all those professionals who are looking to establish their careers as compliance auditors.
The Payment Card Industry Data Security Standard (PCI DSS) is a globally used security standard that was introduced and is still governed by the Payment Security Industry Security Standards Council (PCI SSC). The standard was introduced by the council to tackle the risk of card fraud. This standard applies to all businesses that process, store, or transmit cardholder data.
The standard helps businesses develop a system to protect cardholders’ data by providing businesses a framework for developing or improving their payment card data security process. This process includes the prevention, detection of any breaches, and response to these breaches.
PCI DSS compliance is assessed every year. The assessment depends on the rank of the business. Businesses are ranked by the Payment Card Industry based on the number of card transactions they have annually. This compliance can be reported in the form of Self-Assessment Questionnaires (SAQ) or by using a Qualified Security Assessor (QSA).
Whether a business can use SAQs or QSAs depends on their ranking based on the number of their payment card transactions each year. There are a total of 4 rankings or levels, where level 1 is the highest rank for businesses with more than 6 million annual transactions and level 4 is the lowest rank for businesses with lower than 20,000 annual transactions.
Self-Assessment Questionnaire (SAQ)
Smaller businesses must show their compliance with the PCI DSS through a Self-Assessment Questionnaire (SAQ). Generally, level 3 and level 4 businesses are applicable to use SAQs. There are many different versions of SAQs that a business must use based on how it provides its services.
An SAQ consists of a list of questions that correspond to the PCI DSS requirements designed for businesses. An SAQ also contains an Attestation of Compliance to attest that the person performing the appropriate SAQ is eligible to perform it.
However, some times level 3 and level 4 businesses may not be applicable to show compliance through an SAQ. In some cases, for example, if the card provider company (VISA, American Express, Mastercard, etc.) deems that a business presents an unusual risk, they may direct the business to hire a Qualified Security Assessor (QSA) to complete the audit. This may generally occur after the business has been affected by a security breach.
Level 2 businesses have the choice between whether to self-assess or hire a QSA to complete the PCI audit for them. If these businesses choose to self-assess, then they will also have to go through the same process as level 3 and level 4 businesses.
Qualified Security Assessor (QSA)
Level 1 businesses, do not have a choice to self-assess. These businesses will always have to hire a QSA to perform the audit on their behalf. QSAs are independent security organizations that must pass rigorous tests to receive a qualification from the PCI SSC. These organizations audit business to validate its compliance with the PCI DSS. During the audit, the QSA will perform many tasks, which include the following.
- Verifying all the technical information provided by the business.
- Using independent judgment to confirm the provisions of the PCI DSS have been compiled with.
- Providing support and guidance to the business during the process.
- Being onsite the business during the compliance process.
- Adhering to the PCI DSS Security Assessment Procedures.
- Validating the scope of the audit.
- Evaluating compensating controls.
- Producing the final report.
The QSA will also help the business to calculate any gaps between the processes of the business and the requirements of the PCI DSS. When these gaps are identified, businesses must fix these gaps and ensure no vulnerabilities exist within the system which can threaten unauthorized access to cardholder data.
Once the audit process is complete, the business must report its compliance with the PCI DSS to its respective acquiring financial institution or payment card company. The type of report that will be provided, SAQ, or through a QSA, will depend on the requirements of the payment card company, as mentioned above. Some payment card companies may require a business to submit a quarterly network scanning report as well. The report will generally consist of the following.
- Contact information of the business and the report date.
- Executive summary.
- Description of the scope of work and what approach was taken.
- Details about the reviewed environment.
- Quarterly scan reports.
- Findings and observations.
The Payment Card Industry Data Security Standard is a standard for all businesses that carry out payment card transactions. Businesses have to report their compliance of these standards annually to their respective financial institution or payment card companies.
When reporting their compliance, businesses have the option to either carry out a self-assessment in the form of Self-Assessment Questionnaires (SAQ) or hire a Qualified Security Assessor (QSA), depending on the number of the business’ transactions annually. Level 3 and 4 businesses must use SAQs to report their compliance. Level 2 businesses have the option between SAQ or using QSA. Level 1 businesses do not have the choice to use SAQ and must always use QSA.