Network Billing Compliance Lead — Audits, Training & Policy

Wmchealth; Town of Mount Pleasant (NY); On-site; USD 120,000 - 190,000; Full time

Job summary

Westchester Medical Center Health Network is seeking a Network Manager, Billing Compliance to lead enterprise-wide billing compliance operations, ensuring CMS and state regulations, payer requirements, and organizational policies are met. The role oversees audits, education initiatives, corrective action plans, and cross-functional collaboration to reduce compliance risk and support accurate reimbursement.

Responsibilities include managing audits of professional, hospital, and ancillary

Qualifications

• 5 years of experience in billing compliance
• 3 years of leadership/management with a team of 3–5 people
• Bachelor's Degree in a related field

Responsibilities

• Manage system-wide billing compliance programs and monitoring activities per CMS/state requirements
• Direct routine and targeted audits for professional, hospital, and ancillary services
• Analyze audit findings to identify trends, risks and opportunities; provide feedback to staff and leaders
• Oversee corrective action plans and monitor remediation effectiveness
• Monitor regulatory and payer policy changes impacting billing and reimbursement
• Support external audits, government inquiries, and payer investigations; coordinate responses
• Develop and deliver billing compliance training programs for revenue cycle staff and providers
• Lead and mentor a team of compliance analysts, auditors and specialists
• Promote departmental goals and improve staff KPIs

Skills

Billing compliance

Leadership

Training & mentoring

Communication

Education

Bachelor's Degree

Tools

EPIC

CERner

Workday

Navex

MD Audit

Teams

Job description

Westchester Medical Center Health Network is seeking a Network Manager, Billing Compliance to lead enterprise-wide billing compliance operations, ensuring CMS and state regulations, payer requirements, and organizational policies are met. The role oversees audits, education initiatives, corrective action plans, and cross-functional collaboration to reduce compliance risk and support accurate reimbursement.

Responsibilities include managing audits of professional, hospital, and ancillary