Billing Compliance Auditor III – Hybrid, Flexible Schedule

Boston Children's Hospital; Boston (MA); Hybrid; USD 70,000 - 100,000; Full time

Benefits offered by this job

Flexible schedules

Comprehensive health, vision andDental

Retirement plan (403b)

Tuition and certification reimburse

Paid time off and employee discounts

Job summary

Boston Children's Hospital is seeking a Billing Compliance Auditor III (hybrid) to review clinical documentation and physician billing, ensuring coding accuracy and regulatory compliance across payer systems. The role evaluates risk, prepares audit reports, and collaborates on process improvements and policy drafting with CHB Foundations in coordination with the Hospital.

Requirements include a high school diploma, CPC/CCS-P certification, and 3 years of CPT/ICD-10 coding experience with E/M

Qualifications

• 3 years CPT and ICD-10 coding experience.
• Experience with E/M coding/auditing and physician documentation.
• Knowledge of healthcare billing compliance regulations.

Responsibilities

• Follows established protocols; selects and reviews records to assess coding, billing and reimbursement practices for compliance with regulations.
• Maintains review data and provides feedback to relevant areas; assigns performance scores and risk ratings.
• Investigates and identifies opportunities for improvement; guides departments on internal controls.
• Develops and drafts billing and coding policies for the Foundations in coordination with the Hospital.
• Develops and maintains professional skills through conferences, seminars and literature reviews.
• Contributes to teamwork across departments and provides positive customer service.

Skills

CPT coding

ICD-10 coding

E/M auditing

Healthcare billing compliance

Education

High School Diploma/GED

Associate's or Bachelor's degree preferred

Job description

Boston Children's Hospital is seeking a Billing Compliance Auditor III (hybrid) to review clinical documentation and physician billing, ensuring coding accuracy and regulatory compliance across payer systems. The role evaluates risk, prepares audit reports, and collaborates on process improvements and policy drafting with CHB Foundations in coordination with the Hospital.

Requirements include a high school diploma, CPC/CCS-P certification, and 3 years of CPT/ICD-10 coding experience with E/M