Billing Compliance & Audit Analyst

Pscfl; Miami, Northern (FL, KY); Hybrid; USD 65,000 - 90,000; Full time

Job summary

NCHS is seeking a Billing Compliance Analyst to monitor the Billing Compliance Program, ensuring adherence to federal, state, and local regulations and NCHS policies. The role analyzes outcomes, identifies trends, and reports on risk areas.

You will develop audit activity, propose CAPAs, track training effectiveness, and collaborate with teams to improve billing and coding procedures. Strong data mining, communication, and team collaboration are essential.

Qualifications

• Bachelor's degree required.
• Certified coder CPC, CCS, RHIA, or RHIT preferred.
• 4-7 years of experience in billing compliance or related fields.
• Experience with federal auditing regulations and billing/coding rules.
• Ability to research and communicate billing rules to stakeholders.

Responsibilities

• Analyze Billing Compliance review outcomes and identify trends.
• Develop Billing Compliance audit activity and trends reports.
• Develop recommendations for CAPAs and corrective actions.
• Monitor training effectiveness on billing procedures.
• Collaborate with NCHS members to improve processes.
• Review RAC requests and external recoupment involvement.

Skills

Billing compliance knowledge

Data mining audits

Interpersonal skills

Communication skills

Independent worker

Education

Bachelor's Degree

Tools

CERNER

Job description

NCHS is seeking a Billing Compliance Analyst to monitor the Billing Compliance Program, ensuring adherence to federal, state, and local regulations and NCHS policies. The role analyzes outcomes, identifies trends, and reports on risk areas.

You will develop audit activity, propose CAPAs, track training effectiveness, and collaborate with teams to improve billing and coding procedures. Strong data mining, communication, and team collaboration are essential.