Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Lead Health Information Management Audit Specialist (On-Site)

$21 - $28.26 per hour

Beth Israel Lahey Health

Under direction from the Manager, Health Information Management, a Lead Health Information Management Audit Specialist collaborates closely with other departments and teams to provide efficient and thorough healthcare claims auditing for Beth Israel Lahey Health (BILH) and its affiliates. The Lead is responsible for third‑party audits of medical record data for reimbursement, regulatory compliance, quality, and appropriateness. The role includes medical record documentation review, training and education of colleagues, orientation, monitoring productivity and quality of work standards, updating workflow procedures, and assisting the manager in day‑to‑day activities. The Lead also processes and resolves complex audit compliance transactions. Job Description Assists the manager of the audit in planning and evaluating procedures that support the overall goals and objectives of the HIM and BILH audit processes. Prepares and reports the status and outcome of the various components of the Audit & Compliance section of HIM. Serves as a central communication audit resource to support requirements and proper follow‑up. Assists with overseeing adherence to standards for conducting audits and reviews for the HIM Department and BILH to ensure appropriate release of information in accordance with law and contractual obligations. Works closely with the Director of HIM as needed and the HIM Audit Manager to support new, regulatory compliance issues. Assists in the assignment of tasks and helps resolve technical and operational problems and provides direction and teamwork. Leads and assists with all audits for CMS, CERT, RACs, ADR, Quality, Medical Necessity, DRG insurers submissions, etc. Researches cases, transfers documentation to electronic media, updates the intra‑departmental database, communicates issues and findings to the Director of Internal Audit/Compliance, Director of Case Management, and Coding Manager as appropriate. Coordinates and follows the entire audit appeals process and supports reporting for tracking, financial and risk assessment. Coordinates BILH audits by leveraging Cobius Health for audit tracking and supports various workflows. Reviews billing/claims data in Epic. Researches and analyzes CMS requirements for billing to prevent revenue recoupment and advises the Director of Internal Audit and compliance on non‑compliant Physician Evaluation and Management coding/documentation. Serves as system administrator for Audit tracking system. Follows up and tracks the audit appeal process by monitoring report claims data for financial risks utilizing the audit management system. Prepares graphs and PowerPoint slides for reporting at various venues. Trains external and internal auditors on the navigation of a variety of systems necessary for the completion of audits, including Epic, BILH systems ECMS/Documentum. Possesses strong analytical and problem‑solving software skills. Works with Physicians, Billing, and Administrative personnel throughout BILH to formulate appeals to ensure BILH receives appropriate reimbursement or to correct documentation and billing practices to ensure compliance with Federal law and plan requirements. Provides documentation to the Referral Office to ensure proper billing and reimbursement of requested procedures and testing. Responds appropriately to miscellaneous requests from third‑party payors and the Patient Financial Services department to achieve proper reimbursement, satisfy contractual obligations, and assure compliance with regulations. Demonstrates competency and critical thinking in evaluating and prioritizing auditor requests. Can accurately explain to auditors the requirements and remedies necessary for incomplete requests and escalates as appropriate to manager. Maintains current knowledge base regarding new coding, compliance, and other regulatory issues. Coordinates other audits and projects as assigned by the Manager or assists in completing audits. Minimum Qualifications Education: Clinical background (RN or LPN) and/or HIM degree/Coding certification is strongly preferred, but equivalent working experience may be substituted. Experience: 3‑5 years of healthcare experience is required. Skills, Knowledge & Abilities Knowledge of medical terminology, anatomy and physiology, and general coding guidelines for reimbursement and healthcare processes. Experience using an EHR system, Microsoft Word and Excel. Excellent oral and written communication skills. Demonstrated ability to manage multiple projects simultaneously and independently. Pay Range $21.00 - $28.26 per hour (base hourly wage range). Compensation may exceed the base hourly rate depending on shift differentials, call pay, premium pay, overtime pay, and other additional pay practices, as applicable to the position and in accordance with the law. Equal Opportunity Equal Opportunity Employer/Veterans/Disabled #J-18808-Ljbffr Beth Israel Lahey Health

Vacancy posted 5 days ago
Similar jobs that could be interesting for youBased on the Lead Health Information Management Audit Specialist (On-Site) in Burlington, MA vacancy
  • A healthcare organization in Burlington, Massachusetts is seeking a Lead Health Information Management Audit Specialist to oversee healthcare claims auditing. The ideal candidate will collaborate with various departments, manage audits, and ensure compliance. Candidates... 
    Suggested
    Hourly pay

    Beth Israel Lahey Health

    Burlington, MA
    5 days ago
  • $85k - $120k

     ...partnered with a boutique professional services firm to hire an Audit Specialist . This is a remote work schedule with occasional office...  ...an impressive client roster Occasional visits to client sites, including overnight travel Strong mentorship and... 
    Website
    Work at office
    Remote work
    Flexible hours
    Night shift

    Creative Financial Staffing

    Lexington, MA
    18 hours ago
  • $63.65k - $90.75k

    Mass General Brigham Incorporated seeks a Coding Education Specialist to design, implement, and oversee coding education...  ...guidelines. Candidates should have a Bachelor’s degree in Health Information Management or a related field, along with significant coding and teaching... 
    Suggested
    Remote job

    Mass General Brigham Incorporated.

    Somerville, MA
    2 days ago
  • Australia-Employment, located in Burlington, MA, is seeking a Tax Manager to lead our finance team. The successful candidate will manage tax planning and compliance while optimizing strategies to minimize liabilities. This role requires at least 5 years of experience and... 
    Website
    Local area

    Australia-Employment

    Burlington, MA
    1 day ago
  • $87.5k - $196.5k

     ...Lead, Government Compliance L3Harris Technologies...  ...Systems in SC Ops site reports to the...  ...implementation and management of supply chain and...  .... Coordinate information related to internal/external audits, DCMA CPSR's reviews...  ..., including health and disability insurance... 
    Website
    Full time
    Work experience placement
    Local area
    Flexible hours

    L3Harris Technologies

    Wilmington, MA
    2 days ago
  • $20 - $26.92 per hour

     ...Contributes to Beth Israel Lahey Health's (BILH) mission by providing support to the Health Information Management Department and by providing...  ...be. This role is located on-site at 8 Presidential Way, Woburn...  ...coordination of third-party audits of medical records as necessary... 
    Website
    Hourly pay
    Contract work
    Immediate start
    Flexible hours
    Shift work

    Beth Israel Lahey Health

    Woburn, MA
    2 days ago
  • $132.4k - $251.6k

     ...problems. With our three market leading businesses, world-class...  ...reviews, risk and opportunity management, and program excellence processes...  .../contracts/efforts at remote sites, particularly Site Quality...  ...security clearance process. More information about Security Clearances can... 
    Website
    Temporary work
    Work experience placement
    For subcontractor
    Work at office
    Local area
    Remote work
    Flexible hours

    RTX

    Woburn, MA
    2 days ago
  • A leading aerospace firm in Wilmington is seeking an Information Systems Security Officer to provide security support for both DoD and Non-DoD classified systems....  ...TOP SECRET clearance. This position is strictly on-site and involves occasional travel to other sites. #J-... 
    Website

    Cessna Aircraft Company

    Wilmington, MA
    2 days ago
  • $90k - $120k

    ExecuSource is looking for a BIM Manager in Burlington, MA to lead coordination and constructability for commercial construction projects. The ideal...  ...engineers, producing coordination drawings, and visiting project sites. Offering a salary of $90,000 - $120,000 plus benefits.... 
    Website
    Work at office

    ExecuSource

    Burlington, MA
    5 days ago
  • Harbor Group International is seeking an Assistant Property Manager in Wilmington, Massachusetts. This role supports the Property Manager with daily operations of a multifamily residential community, including rent collection, leasing, and resident relations. The ideal... 
    Website

    Harbor Group International

    Wilmington, MA
    3 days ago
  • Young World Physical Education in Burlington is seeking a Program Site Coordinator for the After-School Program for the 2026/2027 school year. The coordinator will oversee all daily operations, ensuring a safe and engaging environment for children, while supervising teachers... 
    Website

    Young World Physical Education

    Burlington, MA
    3 days ago
  • Leidos Inc in Bedford, MA is seeking an Acquisition Program Support professional responsible for planning and managing resources to successfully execute acquisition and program objectives. The role requires collaboration with various teams, oversight of project performance... 
    Website

    Leidos Inc

    Bedford, MA
    4 days ago
  •  ...Controller in Bedford, Massachusetts. This position involves leading the general ledger and close process, managing the accounting team, and ensuring compliance with...  ...executive leadership, with a work expectation of 3 days on-site. #J-18808-Ljbffr Brennan Staffing Group Inc.
    Website

    Brennan Staffing Group Inc.

    Bedford, MA
    1 day ago
  • $48 per hour

     ...currently looking for a Lead Heavy Duty Mechanic to...  ...for Clean Harbors? Health and Safety is our #1 priority...  .... Complete warranty information. Disassemble,...  ...environment, Clean Harbors is on-site, providing premier...  ...: Fleet & Asset Management Posting Date: 2026-... 
    Website
    Full time
    Casual work
    Weekend work

    Clean Harbors

    Cambridge, MA
    1 day ago
  • $30k

     ...L3Harris Technologies is seeking a Lead, CAD Designer for their Wilmington, MA site. This role will support projects through all phases, maintaining product...  ...design, specially with PTC CREO, and must be able to manage complex models with minimal oversight. The position... 
    Website
    Relocation package

    L3Harris Technologies

    Wilmington, MA
    2 days ago
  •  ...Benefits: 401(k) Health insurance Paid time off Parental...  ...knowledge is put to good use, where management encourages innovative thinking...  ...have an opening for a lead carpenter with 10+ years' experience...  ...carpenter, project manager or site supervisor. If you have your... 
    Website
    For subcontractor
    Relocation package

    Ericson Construction LLC

    Woburn, MA
    4 days ago
  • $160k - $220k

    Australia-Employment is seeking a Civil Superintendent in Burlington, MA to lead heavy-civil construction projects. This permanent role involves project leadership, managing timelines, and ensuring team effectiveness. The ideal candidate has over 5 years of experience supervising... 
    Website
    Permanent employment

    Australia-Employment

    Burlington, MA
    5 days ago
  • $28 per hour

     ...Mon-Fri Schedule About This Position The Site Lead is a critical role in the company. This...  ...meals, leading a team of cooks and preps, managing daily prep and administration of each...  ...standards as outlined by the Department of Health & Mental Hygiene for a food safe... 
    Website
    Hourly pay
    Full time
    Immediate start

    Genuine Foods

    Bedford, MA
    1 day ago
  •  ...to join their team in Burlington, Massachusetts. This role involves overseeing specific trades on construction sites, ensuring safety compliance, and managing field operations. The ideal candidate should possess a Bachelor’s degree in Engineering or Construction Management... 
    Website
    For subcontractor

    IPS-Integrated Project Services, LLC

    Burlington, MA
    5 days ago
  • $120k - $149k

    Lead, Manufacturing Performance Analytics Entegris...  ...manufacturing performance across sites. The Role The...  ...drive adoption of visual management tools to identify...  ...technical problems and inform business decisions. Maintain...  ...vesting. Excellent health, dental, and vision insurance... 
    Website
    Local area

    Entegris

    Billerica, MA
    1 day ago
  • $19.5 - $26.24 per hour

     ...keeping the patient care team informed by maintaining accurate and timely...  ...Reports to the Nurse Manager. Works under the direction of...  ...hospital departments and off-site providers. Arrange ambulances...  ...Disassemble medical chart according to Health Information Management... 
    Website
    Work experience placement
    Work at office
    Shift work

    Beth Israel Lahey Health

    Winchester, MA
    1 day ago
  • $105k - $125k

    Overview We are recruiting for a Program Manager for the Engineering, Professional, and...  ...deploy modernization efforts to multiple sites/sides/strings. Support activities that...  .... Space Force acquisitions. Additional Information: Location: Hanscom Air Force Base Hybrid... 
    Website
    Full time
    Contract work
    For contractors
    Work at office
    Local area
    Remote work

    Apogee Engineering, LLC

    Bedford, MA
    2 days ago
  • A leading aerospace manufacturing company in North Billerica is seeking a Site Quality Manager to drive quality functions and continuous improvement. The role requires strong expertise in AS9100 and ISO 9001, along with proven leadership skills and experience in quality... 
    Website

    Cristek

    Billerica, MA
    1 day ago
  • Planet Pharma Group in Cambridge seeks a Senior Clinical Data Manager to lead clinical data management for trials from startup to database lock...  ...GCP and regulatory standards. The position emphasizes a collaborative, on-site work culture. #J-18808-Ljbffr Planet Pharma Group
    Website

    Planet Pharma Group

    Cambridge, MA
    5 days ago
  • $109.6k - $150.7k

    ## Lead Analyst, Supply Chain PlanningApplylocations...  ...units, manufacturing sites, and regions.* Lead...  ...lot release, bottleneck management, and tradeoff analysis...  ..., work-in-process health, cycle time, capacity...  ...medical condition, genetic information, military or veteran... 
    Website
    Permanent employment
    Work at office
    Day shift

    Analog Devices, Inc.

    Wilmington, MA
    5 days ago
  • $16 - $18 per hour

     ...Lead Sales Associate (Seasonal) Job Category: Retail Part-Time On-site BILLERICA, MA 01821, USA Job Details DIVE IN TO...  ...customers and support the General Manager in all facets of retail...  ...laws. For further information, please review the Know Your... 
    Website
    Hourly pay
    Part time
    Seasonal work

    Leslie's Poolmart

    Billerica, MA
    3 days ago
  • $170k - $200k

    ## Senior Manager, Internal Audit, ITApplylocations: Bedford, MAtime...  ....***The Role**Our site in Bedford, Massachusetts...  ...is seeking an **Information Technology Internal Audit...  ...Audit’s senior lead for **data governance...  ...career, improve your health, or protect your wealth... 
    Website
    H1b
    Work at office

    Entegris Inc.

    Bedford, MA
    5 days ago
  • $30k

     ...national security. Job Title Lead, CAD Designer (Space...  ...growing Wilmington, MA site. As part of the...  ...processes and must be able to manage large, complex project...  ...of benefits, including health and disability...  ...status, disability, genetic information, citizenship status, characteristic... 
    Website
    Local area
    Immediate start
    Relocation package
    Flexible hours

    L3Harris Technologies

    Wilmington, MA
    5 days ago
  •  ...Claims Supervisor - Injury Management Group Cabot Risk Strategies...  ..., we provide our clients a leading property, liability and...  ...people. Please visit our web site at: Purpose and Description...  ...to ensure a smooth efficient information flow. # Undertake projects... 
    Website
    Work experience placement
    Work at office
    2 days per week
    3 days per week

    Cabot Risk Strategies Llc

    Woburn, MA
    22 days ago
  • $116k - $145k

    The Importance of the Role Lead Data Manager, Clinical Data Management is responsible for providing...  ..., vendors, investigators, and clinical sites, as applicable. Provide coaching and...  ..., preferably in a scientific area or health‑related discipline. A minimum of 5 years... 
    Website
    Work at office

    Sarepta Therapeutics

    Cambridge, MA
    4 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Lead Health Information Management Audit Specialist (On-Site). Be the first to apply!