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
$93.8k - $106k
...Institute in Brookline is seeking a Billing Compliance Reviewer to manage audits and ensure compliance with CMS guidelines. This role focuses... ...clinical teams to improve coding practices. Qualified... ...five years of experience in healthcare coding and possess a relevant...Cms$93.8k - $106k
ARMA International in Brookline, Massachusetts, is seeking a Billing Compliance Reviewer. This role entails planning and executing audits,... .... The ideal candidate will have a strong background in healthcare coding and auditing. The position offers a salary range of $93,80...Cms- ...Responsible for ensuring proper coding compliance, documentation accuracy, and... ...and Medicaid Services (CMS), and other regulatory bodies... ...Associate's Degree Medical Billing and Coding preferred Licenses... ...interact effectively with healthcare providers and billing staff....Cms
$25.39 - $40 per hour
...Clinical Modification) diagnosis codes and Current Procedural... ...level of complexity and ensures compliance with coding guidelines, documentation... ...Queries physicians or other healthcare providers for clarification... .... Submits coded claims to billing department or third-party...CmsHourly payShift work$22.22 - $31.71 per hour
...Medical Coding Specialist Mass General Brigham... ...ensuring proper coding compliance, documentation accuracy... ...and Medicaid Services (CMS), and other regulatory... ...'s Degree Medical Billing and Coding preferred.... ...interact effectively with healthcare providers and billing...CmsHourly payRemote workShift work- ...Summary The Inpatient Coding Specialist is responsible... ...encounters in compliance with federal regulations... ...Associate's Degree in Medical Billing and Coding preferred... ..., AHA Coding Clinic, CMS regulations, and payer... ...to collaborate with healthcare providers, coders, and...CmsRemote jobMonday to FridayFlexible hours
- ...Coder will be a part of an emerging coding team under the billing and credentialing service that performs... ...billing. Communicates with healthcare providers to clarify coding questions... ...coding and documentation guidelines, compliance policies, annual coding updates, payer...CmsWork at office
$27.02 per hour
...Condition Category (HCC) Coding, medical coding, clinical... ...Medicare and Medicaid Services (CMS) coding guidelines, and... ..., team members, Quality, Compliance, partners at Enterprise... ...degree in medical billing/coding, health insurance, healthcare or related field preferred...CmsFor contractorsWork at officeLocal areaRemote workFlexible hours$79k - $99.75k
...it!Zelis is modernizing the healthcare financial experience across payers... ...industry standard inpatient coding guidelines and rules,... ...determine accuracy of the DRG billed, based on industry standard coding... ..., relatedness, and compliance with readmission policies.* Based...CmsFull timeWork at officeLocal areaRemote workVisa sponsorshipFlexible hours- The Billing Specialist - is a Medical Biller that manages the full revenue... ...) Transports to ensure proper CMS compliance. This position requires a blend of healthcare administration, financial tracking... ...appropriate ICD and Healthcare codes. Healthcare Provider...CmsFull timeWork at office
$62.5k - $91k
...: Assigns appropriate codes to reflect all diagnoses... ...accurate coding for billing. Sequences diagnoses,... ...the various DRG systems (CMS DRGs, AP-DRG, and APR-DRGs... ...with members of the healthcare delivery team and staff... ...information and ensure compliance of HIPAA rules and regulations...CmsFull timeFixed term contractFlexible hours$78k - $113k
...The Manager of Risk Adjustment Coding manages the day-to-day... ...for our patients and reduce healthcare costs. The incumbent is a working... ...knowledge of regulatory and compliance changes impacting Risk Coding... ...health records, computerized billing and charging systems, Microsoft...CmsFixed term contractFlexible hours$78k - $113k
...Position: Manager Professional Billing Coding Operations - Remote... ...edits and denials and ensures compliance with payer guidelines. The Manager... .... Provides training to healthcare professionals, coders, and Revenue... ...(including E&M coding), CMS National Coverage Determinations...CmsRemote jobFull timeFlexible hours$74k - $110k
...Description We are a healthcare technology company that... ...The Pharmacy Network Auditor is responsible for the... ...responsible for assuring compliance with client contract... ...erroneous, or abusive billing activity... ...knowledge of URAC and CMS network requirements in...CmsContract work- ...Inpatient Auditing Specialist who will address consulting and educational needs related to coding quality and compliance. This role is crucial for shaping the future of healthcare from a fully remote workspace. Responsibilities include conducting audits, providing coder...Remote jobFlexible hours
$57.4k - $99k
...based on experience The Physician Coding Auditor develops and implements strategic needs... ...guidance and leadership to coding and billing management in the implementation and... ...Immediately provides reports related to compliance risks when requested. Experience...Temporary workWork at officeImmediate startRemote work- ...Billing Compliance Reviewer Reporting to the Director of Billing Compliance... ...analyzes documentation and coding for medical necessity and... ...selection in alignment with CMS, OIG, and other applicable professional... ...5 years of experience in a healthcare coding environment....Cms
$83.4k - $91.1k
...The Billing Compliance Curriculum Development Specialist is responsible for... ...evidence-based, and aligned with CMS, OIG, NCCI, payer guidance,... ...billing, documentation, and coding requirements. Knowledge,... ...: •Bachelor's Degree. Healthcare Administration, Health Information...CmsWork at officeRemote work$62.5k - $91k
...Summary Assigns appropriate codes to reflect all diagnoses... ...can be coded and billed in a timely fashion. Maintains... ...CPT‑4, and DRG systems (CMS‑DRGs, AP‑DRG, APR‑DRGs);... ...to collaborate with healthcare team; strict confidentiality and HIPAA compliance; solid communication skills...CmsFlexible hours$95k - $120.65k
...let’s get to it!Zelis is modernizing the healthcare financial experience across payers,... ...medical records utilizing ICD-10 Official Coding Guidelines, AHA Coding Clinic evidence based... ...to determine accuracy of the DRG billed, based on industry standard coding guidelines...CmsFull timeWork at officeLocal areaRemote workVisa sponsorshipFlexible hours$25.5 - $36.49 per hour
...visit and translating the information into codes that insurers use to process claims from... ...required or Associate's Degree Medical Billing and Coding preferred. Can this role... ...skills to effectively collaborate with healthcare providers, coders, and other stakeholders...CmsHourly payRemote work- ...Coder works independently to manage complex coding review, validation, and charge... ...while partnering closely with physicians, billing teams, and operational staff to resolve... ...issues. Review and edit physician queries in compliance with hospital policies and coding standards...CmsFull timeFlexible hours
$116.7k - $132k
...Reporting to the Director of Billing Compliance, the Senior Billing... ...appropriateness of ICD-10-PCS procedure coding and assessing DRG assignment... ..., Mass General Brigham Healthcare, Boston Children's Hospital... ...Abilities: Knowledge of CMS (Medicare and Medicaid) and...CmsWork at officeFlexible hours$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- ...country, serving clients across healthcare, life sciences, education,... ...setup, labor tracking, and cost coding Prepare financial reports,... ...Management teams to ensure billing accuracy Monitor project... ...management processes Ensure compliance with company policies and...CmsFull timeContract workTemporary workFor contractorsWork at office
- Join a mission-driven healthcare system where your expertise directly supports... ..., including audit readiness, compliance, and regulatory adherence Drive split-billing operations, data analytics, and... ...regulatory requirements (DPH, BORP, TJC, CMS, FDA, USP) Experience with...CmsContract workWork at officeRemote workFlexible hours
$92.96k - $125.09k
...in people’s lives. This position is responsible for facilitating the coding, auditing and billing process according to CMS, BIDMC, other federal insurance programs, third-party billing and compliance regulations and guidelines. Oversees and directs efforts across the...CmsWork experience placementInterim role$90k - $110k
...currently seeking a full-time Healthcare Attorney with professional experience... ..., regulatory, and compliance matters. At The Phia Group, whose... ...DOL, and the IRS Knowledge of CMS billing and payment rules and processes, or medical coding generally Confidence in public...CmsFull timeWork at officeFlexible hours$55k
...coordination for One Care enrollees with complex healthcare needs. Successful care delivery is... ...tasks required for functioning and billing of One Care services provided to membership... ...maintain operational systems to ensure compliance to CCA quality measures and contractual...CmsWork at office$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
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