Senior Manager, Billing Compliance

Overview

Reporting to the Director of Billing Compliance, the Senior Manager of Billing Compliance provides strategic and operational leadership for the organization’s billing compliance program, with responsibility for billing compliance education, auditing, monitoring, and risk mitigation activities that support adherence to federal and state regulations, payor requirements, and industry standards. This role serves as a senior billing compliance subject matter expert and key liaison across compliance, revenue cycle, operations, research, and clinical leadership, while directly managing a team of six staff members, including three Senior Billing Compliance Reviewers. The Senior Manager is responsible for preparing the material and may report to executive leadership and board level committees.

The Senior Manager of Billing Compliance supports key organizational growth initiatives by providing targeted oversight of billing compliance education and awareness programs for physicians, practitioners, coders, billers, and other workforce members; leading audit follow-up, post-audit feedback, and tracking of results; helping establish departmental procedures, workplans, and performance metrics; and supporting organizational initiatives, including Epic build, new clinical partnerships, and ambulatory expansion.

Located in Boston and the surrounding communities, Dana-Farber Cancer Institute is a leader in life changing breakthroughs in cancer research and patient care. We are united in our mission of conquering cancer, HIV/AIDS, and related diseases. We strive to create an inclusive, diverse, and equitable environment where we provide compassionate and comprehensive care to patients of all backgrounds, and design programs to promote public health particularly among high-risk and underserved populations. We conduct groundbreaking research that advances treatment, we educate tomorrow's physician/researchers, and we work with amazing partners, including other Harvard Medical School-affiliated hospitals.

Primary Duties and Responsibilities

• Serve as the organizational expert on billing compliance requirements by providing guidance on federal, state, local, government, and commercial payor regulations affecting hospital and professional billing. Serve as the primary resource for billing compliance matters across all position levels within the organization, advising leadership, providers, staff, and key stakeholders. Maintain current knowledge of diagnosis and procedure coding classifications (i.e., ICD-10-CM, HCPCS Level II, and CPT-4), documentation standards, regulatory developments, and translate changes into practical operational guidance.
• Lead the development and administration of the billing compliance program infrastructure to support consistent, effective, and sustainable operations. Oversee the development, implementation, maintenance, and communication of policies, procedures, standardized workflows, and departmental performance metrics to ensure alignment with applicable laws, regulations, and industry standards. Establish processes for education and training, executive- and board-level reporting, operational support, and integration of new partnerships, service lines, and organizational initiatives.
• Oversee billing compliance audit, monitoring, and risk management activities to identify vulnerabilities and promote corrective action. Coordinate internal and external audits, investigations, focused reviews, probe audits, and full audits based on regulatory policies, industry trends, prior findings, and organizational risk assessments. Prepare written audit reports, communicate recommendations, and present findings to executive leadership as appropriate while ensuring quality, consistency, and completeness in audit activities.
• Support the development and execution of the billing compliance workplan in collaboration with leadership to promote compliant billing and coding practices across hospital and professional services. Evaluate risks associated with operational changes, research billing, new care delivery models, clinical partnerships, hospital development, and ambulatory expansion. Recommend priorities and mitigation strategies based on regulatory guidance, oversight body workplans, and healthcare compliance best practices.
• Design and oversee a comprehensive billing compliance education program to support and guide leaders, staff, physicians, and advanced practice providers. Develop presentations, educational materials, and practical tools addressing billing compliance, coding, and documentation requirements, and provide oversight to staff responsible for curriculum development and maintenance. Deliver ongoing education and targeted guidance to strengthen organizational understanding of compliance expectations and improve billing and documentation performance.
• Cultivate strong cross-functional partnerships and communication channels among compliance, legal, operations, research, revenue cycle, information systems, and clinical leadership. Serve in key committee and governance roles to advance strategic priorities, resolve issues, and promote enterprise-wide alignment of billing compliance matters. Prepare and communicate compliance updates, performance metrics, risk assessments, and strategic recommendations to executive leadership and the Board, as appropriate.
• Provide billing compliance leadership for strategic initiatives and organizational transformation efforts to ensure regulatory requirements are integrated into growth and change management activities. Partner with operational and clinical leaders to embed compliance considerations into workflow design, system configuration, documentation practices, and process improvement initiatives. Support major efforts such as new clinical partnerships, hospital expansion, ambulatory growth, and Epic-related billing build and optimization activities.
• Supervise the billing compliance team. Hire, develop, mentor, and manage staff to achieve departmental and organizational goals. Set clear expectations, provide regular coaching and feedback, and monitor staff performance for quality, productivity, efficiency, and compliance with organizational policies and procedures. Assign work across the team based on departmental priorities, staff expertise, and business needs. Foster career growth, professional development, accountability, collaboration, and a positive, high-performing work environment. Serve as a key member of the team by promoting a culture of integrity, respect, and continuous improvement.

Knowledge, Skills and Abilities

• High ethical standards and commitment to billing compliance with a strong knowledge of healthcare billing regulations and compliance standards.
• Ability to interpret complex billing compliance requirements to organizational policies and procedures.
• Knowledge of CMS (Medicare and Medicaid) and commercial payers billing and documentation.
• Demonstrated proficiency in billing compliance and ethics standards in complex health care environments.
• Commitment and ability to work in a team-based environment, manage patient and highly reputable faculty and interactions/communication with extreme care, patience, confidentiality, and consideration, and maintain an environment with open channels of communication within the Institute with workforce members, patients, and others.
• Excellent organization, attention to detail, technical and analytical skills. Ability to gather relevant information systematically, break down problems into essential components and make sound decisions. Ability to approach problems with curiosity and open-mindedness and offer new ideas, solutions and/or options.
• Demonstrated discretion, diplomacy, and good judgment.
• Effective communication and presentation skills with the ability to clearly and concisely express ideas in groups and one-to-one conversations, formal and informal documents. Ability to adapt strong writing and communications styles to fit the audience.
• Self-starter, positive attitude, ability to work independently, enjoys learning and staying current with industry developments, regulations, and best practices.
• Demonstrated knowledge in setting and achieving challenging goals.
• Adaptability to a fast-paced environment and ability to thrive in a dynamic work setting, balancing multiple responsibilities while maintaining effectiveness.
• Strong interpersonal skills to foster a collaborative team environment.
• Technical capability to utilize multiple information systems and computer applications, including advanced PowerPoint and Excel functions.

Minimum Job Qualifications

• Bachelor’s degree required. Master’s degree preferred.
• 6 years of experience in billing compliance required.
• 1 year of experience in a management role required.
• Epic EHR experience preferred.
• Familiarity with Adobe Captivate and Elucidat preferred.

License/Certification/Registration Required:

• Certified coder (AHIMA or AAPC) required.
• Additional specialty coding/auditing certifications required.

Supervisory Responsibilities: Yes

• Directly supervises Billing Compliance Reviewers, Senior Billing Compliance Reviewers, and Billing Compliance Educator (6 FTE).

Patient Contact: No

At Dana-Farber Cancer Institute, we work every day to create an innovative, caring, and inclusive environment where every patient, family, and staff member feels they belong. As relentless as we are in our mission to reduce the burden of cancer for all, we are committed to having faculty and staff who offer multifaceted experiences. Cancer knows no boundaries and when it comes to hiring the most dedicated and compassionate professionals, neither do we. If working in this kind of organization inspires you, we encourage you to apply.

Dana-Farber Cancer Institute is an equal opportunity employer and affirms the right of every qualified applicant to receive consideration for employment without regard to race, color, religion, sex, gender identity or expression, national origin, sexual orientation, genetic information, disability, age, ancestry, military service, protected veteran status, or other characteristics protected by law.

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Pay Transparency Statement

The hiring range is based on market pay structures, with individual salaries determined by factors such as business needs, market conditions, internal equity, and based on the candidate’s relevant experience, skills and qualifications.

For union positions, the pay range is determined by the Collective Bargaining Agreement (CBA).

$114,500.00 - $134,700.00