Billing Compliance Analyst: Audit & CAPA Specialist

Nicklaushealth; Miami (FL); On-site; USD 75,000 - 110,000; Full time

Job summary

Nicklaushealth is seeking a Billing Compliance professional to monitor regulatory adherence and analyze outcomes. You will identify trends, develop corrective actions, and collaborate to improve billing procedures across departments.

The role requires 4–7 years in billing compliance, with credentials such as CPC/CCS/RHIA/RHIT, and familiarity with Cerner. Excellent communication and teamwork are essential in a deadline-driven environment.

Qualifications

• Bachelor's degree required with healthcare data or billing experience.
• Certification CPC/CCS/RHIA/RHIT preferred for billing compliance work.
• Experience with federal, state, and payer billing rules and audits.

Responsibilities

• Monitor Billing Compliance activities for regulatory adherence.
• Analyze review outcomes; identify trends and high-risk areas.
• Develop CAPAs and provide training to staff on billing procedures.
• Prepare reports on audit activity and effectiveness of risk controls.
• Collaborate with teams to improve billing/coding processes.
• Research changes in national/local coding and billing decisions.
• Support RAC requests and other external recoupment inquiries.
• Maintain records of trainings and education provided.

Skills

Attention to detail

Analytical thinking

Communication skills

Team collaboration

Independent work

Education

Bachelor's Degree

Certified Coder CPC/CCS/RHIA/RHIT

Tools

Cerner

Job description

Nicklaushealth is seeking a Billing Compliance professional to monitor regulatory adherence and analyze outcomes. You will identify trends, develop corrective actions, and collaborate to improve billing procedures across departments.

The role requires 4–7 years in billing compliance, with credentials such as CPC/CCS/RHIA/RHIT, and familiarity with Cerner. Excellent communication and teamwork are essential in a deadline-driven environment.