Billing and Compliance Audit Specialist - Remote

Overview

The Billing and Compliance Audit Specialist is responsible for conducting comprehensive internal billing and compliance audits, managing interactions with payors and third parties for external audits, and developing robust training and Standard Operating Procedures (SOPs) for the reimbursement team. This role plays a critical part in ensuring compliance with regulatory requirements and optimizing reimbursement processes.

In Short

• Perform regular internal billing and compliance audits.
• Analyze audit findings and recommend corrective actions.
• Manage external audit lifecycle with payors and third parties.
• Collaborate with legal counsel for compliance assurance.
• Conduct training for the reimbursement team.
• Develop training materials and SOPs.
• Report audit findings to the VP of Reimbursement.
• Present detailed audit reports to key leaders.

Requirements

• Bachelor’s degree in Finance, Business Administration, or related field preferred.
• Certified Professional Coder or similar certification preferred.
• Experience in billing and compliance audits in healthcare.
• Strong understanding of reimbursement processes.
• Excellent communication and interpersonal skills.
• Ability to develop training materials.
• Proficient in data analysis.
• Detail-oriented with strong analytical skills.
• Strong organizational and time management skills.
• Proficient in audit and compliance software tools.

Benefits

• Working with a team of ‘rockstars’.
• Open, transparent culture with weekly Town Hall meetings.
• Ability to impact the lives of patients.
• Multiple medical benefit options with premiums covered.
• Generous Family Bonding Leave for new parents.
• Retirement savings program with company match.
• Free daily on-site lunches.
• Latest hardware and lab equipment provided.
• On-campus perks including gym and restaurant.
• Free on-site EV charging.