Billing Compliance Educator

Overview

Reporting to the Manager of Billing Compliance, the Billing Compliance Curriculum Development Specialist (also known as the "Billing Compliance Educator") is responsible for designing, implementing, and maintaining a comprehensive billing compliance education and awareness program that supports adherence to federal and state regulations and aligns with industry standards. This role develops and delivers training for billing providers, including physicians and advanced practice providers, and provides post-review education and feedback in collaboration with Billing Compliance Reviewers and Senior Billing Compliance Reviewers, as needed. The Specialist creates, updates, and manages instructional materials such as presentations, tip sheets, slide decks, and other training resources, and tracks training completion and effectiveness. The position also supports the evaluation, customization, and implementation of online documentation and billing education for students, residents, fellows, and other non-billing providers. In addition, the Specialist maintains and updates MRO Cobius Physician Audit Review Manager and Institutional Audit Review Manager modules for billing providers following training and tracks and trends review results as appropriate. This role participates in committees, work groups, and special projects as assigned and serves as a resource to promote accurate, compliant billing and documentation practices through education, documentation review, identification of compliance concerns, and ongoing regulatory support.

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:

• Designs, develops, and maintains a comprehensive billing compliance education program for physicians, advanced practice providers, coders, reviewers, managers, and revenue cycle staff, including onboarding, annual training, and targeted risk-based education.
• Develops, updates, and maintains educational materials, including presentations, reference guides, job aids, assessments, and virtual learning modules, to support role-specific compliance training.
• Delivers billing compliance education through live, virtual, small-group, and one-on-one formats using effective adult learning principles and instructional methods.
• Provides onboarding and ongoing billing compliance training for newly employed physicians, advanced practice providers, and staff, including coverage for educator responsibilities as needed.
• Partners with compliance reviewers, department leadership, and revenue cycle operations to reinforce review findings, improve billing and documentation practices, and support corrective action efforts.
• Researches coding, billing, documentation, and regulatory issues; responds to questions; and communicates relevant updates and annual changes to physicians, advanced practice providers, coding staff, and billing compliance personnel.
• Maintains current knowledge of ICD-10-CM, CPT, HCPCS Level II, and applicable billing, coding, documentation, and specialty-specific regulatory requirements.
• Incorporates guidance from CMS, OIG, NCCI, and other applicable regulatory and payer sources into training content, communication tools, and compliance education strategies.
• Analyzes review, quality, and compliance data to identify educational gaps, measure training effectiveness, and track participation and outcomes.
• Assists with special projects, internal reviews, investigations, reviews, and responses to inquiries from federal, state, or other external agencies.
• Maintains the privacy of patient information and the confidentiality of compliance-related information, investigations, and activities.
• Identifies annual professional development goals and pursues ongoing learning to maintain subject matter expertise and support continuous improvement.
• Performs other related duties as assigned.

Knowledge, Skills and Abilities:

• Advanced knowledge of billing compliance regulations and coding guidelines, including ICD-10-CM, CPT, and HCPCS
• Strong instructional design and adult learning skills
• Excellent written and verbal communication skills
• Strong analytical skills with the ability to translate data into actionable education
• Proficiency in Microsoft Office, including Word, Excel, and advanced PowerPoint skills for developing effective presentations and training materials
• Ability to develop, implement, and maintain e-learning modules within a learning management system (LMS)
• Strong organizational skills and ability to manage multiple priorities
• Ability to work independently in a remote environment

Minimum Job Qualifications:

• Associate's degree in Health Information Management, Education, or related field required.
• Minimum of 5 years of experience in healthcare billing, coding, auditing, compliance, and/or education.
• Demonstrated experience in curriculum development, training delivery, and provider education.
• Experience in oncology professional and technical coding, auditing and billing compliance preferred.
• Experience supporting enterprise billing compliance and audit programs preferred.
• Experience with Epic preferred.
• Experience developing virtual or asynchronous learning content preferred.

License/Certification/Registration Required:

One or more of the following certifications required: CPC, CCS, CCS-P, CPMA, COC, RHIT, RHIA

Supervisory Responsibilities:

None

Patient Contact:

None

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).

$93,800.00 - $106,000.00