Healthcare Billing Compliance Leader

Brault; San Dimas (CA); On-site; USD 110,000 - 125,000; Full time

Job summary

Brault in the United States (California) seeks a Compliance Manager to ensure adherence to government laws, regulations, and company policies. You will lead the compliance program, train staff, review certifications, and coordinate with HR and providers to mitigate risks.

Responsibilities include Medicare audits, handling complaints, guiding coding/billing decisions, and improving processes to prevent fraud and waste.

Qualifications

• Undergraduate degree preferred in related field.
• Extensive knowledge of ICD10-CM and CPT coding principles.
• Extensive knowledge of federal regulations for physician documentation, coding, and billing.
• 4+ years coding experience.
• 3+ years auditing experience.
• 1-2 years supervisory experience.
• Experience in medical billing and compliance in healthcare preferred.

Responsibilities

• Process Medicare pre- and post-payment audits.
• Address compliance or provider-service complaints.
• Research coding or billing questions with leadership to ensure regulatory compliance.
• Lead internal reimbursement-coding audits and report findings bi-monthly.
• Provide CPT code updates when CPT manuals are revised.
• Train staff on payment deficiencies and resolution with payers.

Skills

Excellent organizational skills

Excellent written and oral comms

Excellent analytical skills

Education

Undergraduate degree in related field preferred

ICD10-CM and CPT coding knowledge

Regulations and policies knowledge for physician coding and billing

4+ years coding experience

3+ years auditing experience

1-2 years supervisory experience

Experience in medical billing and compliance in healthcare preferred

Job description

Brault in the United States (California) seeks a Compliance Manager to ensure adherence to government laws, regulations, and company policies. You will lead the compliance program, train staff, review certifications, and coordinate with HR and providers to mitigate risks.

Responsibilities include Medicare audits, handling complaints, guiding coding/billing decisions, and improving processes to prevent fraud and waste.