CPCO Lead, Medical Billing Compliance

Boston Neurobehavioral Associates; Karachi Division; On-site; PKR 24,924,000 - 33,232,000; Full time

Job summary

Citadel Healthcare Management (PVT) LTD seeks a Certified Professional Compliance Officer to lead the compliance function for medical billing operations in the US market. You will ensure adherence to CMS, CPT, ICD-10, HCPCS, HIPAA, and payer guidelines while overseeing audits and risk management.

The role focuses on policy development, staff training, and effective reporting to leadership, with collaboration across HR, IT, and operations to embed compliance in daily workflows.

Qualifications

• CPCO certification (AAPC) required.
• Bachelor’s degree in healthcare administration, business, or related field.
• 3–5 years of experience in medical billing compliance, auditing, or healthcare regulatory oversight.
• Strong knowledge of CPT, ICD-10, HCPCS, HIPAA, CMS, and payer-specific regulations.
• Experience with denial management and appeals processes.
• Excellent communication, analytical, and leadership skills.

Responsibilities

• Regulatory Compliance Oversight: Ensure billing and coding practices comply with CMS, OIG, HIPAA, and payer-specific guidelines.
• Monitor compliance with CPT, ICD-10, HCPCS, and other coding standards.
• Oversee denial management processes and ensure corrective actions are implemented.
• Audit & Risk Management: Conduct internal audits of claims, coding accuracy, and documentation.
• Identify compliance risks and develop mitigation strategies.
• Prepare for external audits and act as the primary liaison with regulators and payers.
• Policy & Procedure Development: Draft, update, and enforce compliance policies tailored to billing operations.
• Establish protocols for handling denials, rejections, and appeals.
• Training & Education: Provide ongoing compliance training to billing staff, coders, and management.
• Educate teams on regulatory updates, payer requirements, and fraud prevention.
• Reporting & Communication: Generate compliance reports for leadership and stakeholders.
• Communicate audit findings and recommend corrective measures.
• Collaborate with HR, IT, and operations to integrate compliance into workflows.

Skills

CPCO certification

Leadership

Analytical

Communication

Regulatory knowledge

Education

Bachelor’s degree in healthcare administration, business, or related field

Job description

Citadel Healthcare Management (PVT) LTD seeks a Certified Professional Compliance Officer to lead the compliance function for medical billing operations in the US market. You will ensure adherence to CMS, CPT, ICD-10, HCPCS, HIPAA, and payer guidelines while overseeing audits and risk management.

The role focuses on policy development, staff training, and effective reporting to leadership, with collaboration across HR, IT, and operations to embed compliance in daily workflows.