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- ...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$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$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$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- ...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
- ...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
- ...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 officeRemote work
- ...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
- ...(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$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- ...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
$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$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$210k - $282k
...transformative projects in the country, serving clients across healthcare, life sciences, education, gaming, aviation, transportation, government... ...(U.S. and India) while contributing directly to architecture, code, and delivery of production AI systems.You will focus on:...CmsTemporary workFor contractorsWork at office$32 - $42 per hour
...Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world's health data secure, accessible... ...! What You Will Do: Assign diagnostic and procedural codes using ICD-10-CM and ICD-10-PCS codes Accurately sequence and...CmsHourly payReliefRemote workRelocation packageFlexible hours$30.6 - $44.51 per hour
...improving the quality of coding processes,... ...and promoting coding compliance. Essential Functions Develop... ...and Medicaid Services (CMS), and other relevant bodies... ...physicians, and other healthcare professionals to... ...healthcare providers, coders, billing staff, and other...CmsRemote jobHourly payMonday to FridayShift work$63.65k - $90.75k
...general supervision of the Senior Coding Manager the Technical Advisor... ...reviews and audits, new coding/billing regulations impacts, coding and... ...in clinical coding within a healthcare setting, with a focus on coding accuracy and compliance. Knowledge, Skills and Abilities...CmsRemote workShift work$170k - $222.6k
...transformative projects in the country, serving clients across healthcare, life sciences, education, gaming, aviation, transportation, government... ...software engineering experience (not including vibe coding) Demonstrated experience designing distributed or service-oriented...CmsTemporary workFor contractorsWork at office
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