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
$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 employmentWork 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... ...or CCS-P certification, and at least three years of CPT/ICD-10 coding experience, #J-18808-Ljbffr Boston Children’s HospitalSuggested
- ...s clinical model into billing reality. You'll partner... ...payer coverage maps, coding guides, FAQ documents,... ...correct issues early. CMS & Payer Strategy... ...proactive, not reactive, on compliance and reimbursement... ...the billing team. Healthcare consulting with client...CmsFull timeTemporary workPart timeWork at officeRemote workRelocationFlexible hours
$93.8k - $106k
...Reporting to the Manager of Billing Compliance, the Billing Compliance Curriculum... ...efforts. Researches coding, billing, documentation, and... ...Incorporates guidance from CMS, OIG, NCCI, and other applicable... ...of 5 years of experience in healthcare billing, coding, auditing,...CmsWork at officeRemote work$140k - $170k
...Machinify is a leading healthcare intelligence company with expertise across... ...canonical models, applying healthcare coding standards (ICD-10, CPT, HCPCS, UB-04, CMS-1500) throughout Drive payment... ...of benefits issues, and billing edit opportunities by applying deep...CmsDaily paidRemote workFlexible 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- ...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...CmsFull timeLocal 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- ...customer provides inventory services to the healthcare delivery industry. They audit... ...supply chain and pharmacy operations team. Compliance with our customers' requirements is essential... ...inoculations and periodic testing. Auditors will work in warehouses, storerooms,...
- ...regulatory assessment, audits, and accreditation activities across CMS, NCQA, and other programs for the assigned department,... ...candidates with a bachelor's degree and 3 years of PBM, healthcare, or compliance experience, strong communication, analytical thinking, and meticulous...CmsRemote work
$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- ...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
$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- ...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
- ...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
- ...visits as they relate to ICD-10-CM diagnosis coding and reimbursement. The entry level... ...records to ensure completeness, accuracy and compliance with Medicaid coding and supporting... ...expended. In close collaboration with the billing team, reviews medical records...CmsWork at office
$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- ...Vice President, Healthcare Solutions About the Company Innovative provider of cloud-... ...Wellness Electronic Health Record Compliance & Certifications Artificial Intelligence... ...platforms, as well as familiarity with CMS interoperability and prior authorization...Cms
$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- ...general supervision of the Coding Manager - Claim Edits... ...and audits, new coding/billing regulations impacts,... ...workflow adherence and coding compliance. Informs and advises on... ...regulations (OIG), CMS regulatory changes, and... ...preferred. Supervisor/Auditor/Trainer experience is...CmsWork at officeLocal areaRemote work
$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- ...(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
- ...technology initiatives within the healthcare & local state initiatives.... ..., budgets, forecasts, compliance activities, vendor alignment,... ...required to obtain and maintain CMS approval for Medicaid technology... ...Review timecard coding and funding allocations to ensure...CmsContract workLocal area
$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$154.7k - $212.7k
...governments, commercial developers, education and healthcare institutions, industrial clients, and... ..., technical documentation, regulatory compliance, zoning, and permittingDevelop project... ...understanding of design, building codes, permitting, and construction processesProven...CmsFull timeContract workWork at officeRemote work$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
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