Healthcare Billing Compliance Auditor (CMS & Coding)
Dana–Farber Cancer Institute
Dana‑Farber Cancer Institute in Brookline, MA is seeking a Billing Compliance Reviewer to plan and execute risk-based audits of medical necessity and coding accuracy. You will analyze documentation, ensure compliance with CMS, OIG, and payer requirements, and suggest corrective actions to reduce compliance risk. The role collaborates with Coding, HIM, Billing, and clinical teams to remediate findings, develop internal controls, and support ongoing improvement in charge capture and documentation #J-18808-Ljbffr Dana-Farber Cancer Institute
- ...a mission-driven healthcare organization committed... ...a Clinical Compliance Director who is passionate... ..., documentation, billing integrity, and... ...Ensure compliance with CMS, MassHealth, HIPAA... ...managers, auditors, compliance specialists... ...(CPC), Certified Coding Specialist (CCS),...CmsFull timeWork at office
$71.1k - $97.8k
...caring community The Inpatient Medical Coding Auditor extracts clinical information from a... ...encourage personal wellness and smart healthcare decisions for you and your family... ...Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation...CmsBi-weekly payFull timeContract workTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeMonday to Friday$38.46 - $52.4 per hour
...markets they serve. We help healthcare organizations build innovation... ...future. The Inpatient Coding Auditor will be responsible for the... ...documentation guidelines. Monitor compliance of coding guidelines and... ...Medicare/Medicaid Services (CMS) ICD-PCS Official Guidelines...CmsHourly payPermanent employmentFull timeWork at officeLocal areaImmediate startRemote workFlexible hoursDay shift$74k - $110k
We are a healthcare technology company that provides platforms... ...The Pharmacy Network Auditor is responsible for the... ...for assuring compliance with client contract requirements... ...erroneous, or abusive billing activity Responsible... ...knowledge of URAC and CMS network requirements...CmsContract work- ...Boston Children’s Hospital is seeking a Billing Compliance Auditor III to perform audits of clinical documentation and billing records. The role... ...School Diploma or GED, CPC or CCS-P certification, and at least three years of CPT/ICD-10 coding experience, #J-18808-Ljbffr...Suggested
$93.8k - $106k
...Reporting to the Manager of Billing Compliance, the Billing Compliance Curriculum... ...action efforts. Researches coding, billing, documentation, and... ...Incorporates guidance from CMS, OIG, NCCI, and other... ...of 5 years of experience in healthcare billing, coding, auditing, compliance...CmsWork at officeRemote work$84k - $91.31k
Billing Compliance Reviewer job at Dana‑Farber Cancer Institute... ...analyzes documentation and coding for medical necessity... ...in alignment with CMS, OIG, and other applicable... ...of experience in a healthcare coding environment.... ...Professional Medical Auditor), CHC (Certified in Healthcare...Cms- ...Integrity (CDM, charge capture, CDI, coding), and Back-End Operations (billing, collections, denials management,... ...environment, including HIPAA compliance, CMS billing and coding requirements,... ...experienceMinimum of 5 years of healthcare provider Revenue Cycle experience...CmsFull timeLive inWork at officeLocal areaShift work
$154.2k - $170.8k
Reporting to the VP, Chief Compliance Officer with a dotted line reporting... ...Management, the Director of Billing Compliance is a strategic... ...requirements. Monitors changes in healthcare regulations and updates... ...delivers clinical documentation, coding and billing education...CmsLocal area$110.2k - $122.3k
...clinical accuracy and compliance in audit responses and... ...expertise and knowledge of billing practices to address... ...and external auditors, ensuring timely and accurate... ...payer charge and coding audits, ensuring compliance... ...Knowledge of Healthcare Revenue Cycle: Understanding...Remote work- ...A leading healthcare organization in Boston is seeking a detailed-oriented professional to conduct inpatient DRG reviews. The role requires an RN or LVN and an inpatient coding certification within 4-6 months of hire. Responsibilities include performing comprehensive...Remote work
- ...customer provides inventory services to the healthcare delivery industry. They audit... ...supply chain and pharmacy operations team. Compliance with our customers' requirements is essential... ...and periodic testing. Auditors will work in warehouses, storerooms, clean...
$46.99k - $122.4k
...The Program Integrity Auditor is responsible for the... ...transportation, and other healthcare providers. The Auditor... ...to determine correct coding and appropriate... ...recognize any concerning billing patterns or trends. Primary... ...rules. Maintain compliance with company policies...Hourly payFull timeTemporary workLocal areaMonday to FridayFlexible hours- ...locations in New Hampshire and Massachusetts ED coding experience required Preferred candidate... ..., units, NCCI edits, and payer-specific billing rules to ensure compliant charge capture... ...Commitment to confidentiality, HIPAA compliance, and ethical coding practices Preferred...CmsFull timeTemporary workPart timeLocal areaFlexible hours
- ...years of corporate and/or professional services experience, in healthcare, legal, professional services, risk, and/or communicationsDemonstrated... ...data collection with data integrity in case management system (CMS).You will collaborate with CST Leadership and partner...CmsApprenticeshipWork experience placement
- ...assess, and improve the quality of medical coding processes and documentation. You will... ...drive education to enhance accuracy and compliance. The role requires strong knowledge of ICD... ...in inpatient coding and familiarity with CMS/AMA standards. #J-18808-Ljbffr Mass General...CmsRemote job
- Dana-Farber Cancer Institute is seeking a Billing Compliance Curriculum Development Specialist to design, implement, and maintain an education program ensuring adherence to federal and state regulations. You will create materials, deliver trainings to physicians, APPs,...Cms
$89.5k - $130k
...trauma registrars, prioritizes daily workflow, and ensures full compliance with all state and national reporting requirements, including... ...provides clinical expertise and training in AIS and ICD 10 CM coding, supports staff development, and ensures adherence to ACS COT and...CmsFixed term contractFlexible hours$62.5k - $86k
...tables of authorities, and other pleadings, ensuring accuracy and compliance with court requirementsFile and serve motions, briefs, exhibits... ...to manage document reviews and productions (i.e., loading and coding documents, bates numbering, logging productions, and searching...CmsWork at officeRemote work- ...Title: IT Project Manager - Health Plan / CMS Mandates Industry: Information... ...and deliverables Ensure health plan compliance with CMS mandates, interoperability standards... ...Experience working within a health plan or healthcare payer environment ~ Hands-on...CmsFull timeContract workRemote work
$120k - $225k
...Healthcare Litigation Attorney Boston law firm Krokidas & Bluestein LLP , a premier boutique... ...investigations, including DOJ, AG, CMS, and OIG matters; and (4) providing advice... ...to clients on a range of regulatory and compliance issues. In addition, the firm acts as outside...Cms- ...Vice President of Quality & Compliance About the Company Fast-growing provider of in-home healthcare services Industry Hospital & Health Care Type Privately... ...experience, and comprehensive knowledge of CMS Conditions of Participation, PDGM, Medicare &...Cms
$30 - $60 per hour
...Direct full-cycle revenue operations, including billing, collections, and account resolution for all resident... ...Medicaid, Hospice, Medicare, and Managed Care in compliance with Centers for Medicare & Medicaid Services (CMS), MassHealth, and other payer requirements. Verify...CmsFull timeWork at officeLocal areaRemote workMonday to FridayFlexible hours$18 - $32 per hour
...be helping us confirm to very exacting standards such as NCQA, CMS and State credentialing requirements. Schedule: FT, 40 hrs. Monday... ...and entered into the appropriate system/s for scheduling and billing Maintains complete and up to date credentialing file for all...CmsHourly payMinimum wageFull timeTemporary workWork experience placementWork at officeLocal areaRemote workMonday to Friday- ...supporting care planning, documentation, compliance, and day-to-day operations. Reports... ...maintenance Support compliance with CMS, DPH, CHAP regulations Patient & Family... ...Experience in home health, hospice, or healthcare administration strongly preferred Familiarity...CmsWork at officeFlexible hours
- ...(primarily surgeons), nurses, billing staff, administrators, financial... ...of the quarterly CMS drug reimbursable schedule.Develop... ...effectively educate and engage healthcare professionals in dialogue about... ...patient and provider perspective (J codes, CPT codes, billing coding,...CmsWork at officeLocal areaNight shift
$188.6k - $283k
...lives with our solutions in Healthcare, Life Science, and Electronics... ...business goals while ensuring compliance with ethical standards.Key... ...activities comply with FDA, OIG, CMS, and state requirements, as... ...company policies and industry codes (e.g., PhRMA Code)....CmsFlexible hours- ...visits as they relate to ICD-10-CM diagnosis coding and reimbursement. The Level 2 Certified... ...to ensure completeness, accuracy and compliance with Medicaid coding and supporting... ...providers. Experienced with finance and billing systems. Special Requirements: The...CmsWork at office
$133k - $186k
...transformative projects in the country, serving clients across healthcare, life sciences, education, gaming, aviation, transportation,... ...schedule risks.Implement scheduling best practices and ensure compliance with Suffolk’s SOP.Advance technology & data by implementing cutting...CmsTemporary workFor contractorsWork at office$42.79 - $58.17 per hour
...in the country, serving clients across healthcare, life sciences, education, gaming, aviation... ...and Project Management teams to ensure billing accuracyMonitor project expenditures and... ...and document management processesEnsure compliance with company policies and project...CmsContract workTemporary workFor contractorsWork at office
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