Senior Billing Compliance Analyst
Core
Senior Billing Compliance Analyst providing advanced support to the health system's billing compliance program by performing complex audits, leading data analytics activities, and guiding prevention and monitoring strategies.
Role type
Senior IC billing compliance analyst
Builds
Billing compliance audits, data analytics reports, training initiatives, and policy updates
Domain
Healthcare administration and billing compliance
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
ICD-10-CM, CPT, HCPCS coding systems, CMS billing guidelines, OIG work plan focus areas, Epic charge router logic, data analysis, financial modeling, root-cause analysis
Preferred skills
Certified Healthcare Compliance (CHC), audit process experience, data analysis experience
Technologies
Epic, Microsoft 365
Responsibilities
Conducts and manages Hospital and Professional billing compliance audits, reviews, projects and investigations; Develops on-going billing compliance training and awareness initiatives; Analyzes and evaluates data, identifies risks, and makes appropriate conclusions based on audit test work, investigations, and project analysis; Manages the Billing Compliance Program Policy and Procedures life cycle process.
Seniority
Senior, hands-on IC