Regulatory Billing Auditor

MaineGuide; Westbrook (ME); Remoto; USD 66.000 - 89.000; Tempo pieno

Vantaggi offerti da questo lavoro

Remote work (100% remote)

Competitive benefits

Descrizione del lavoro

MaineHealth is seeking a Regulatory Billing Auditor in a 100% remote role to support compliant charging, billing, and documentation across the system. You will audit clinical records, analyze billing processes, and collaborate with leadership to improve compliance and revenue integrity.

The role requires 5+ years in coding/billing/compliance with 2–3 years in medical auditing, CPC/COC/RHIT/RHIA/CCS/CCS-P certifications, and offers strong growth within MaineHealth’s integrated network.

Competenze

• High school diploma required; medical billing/coding coursework preferred.
• Certifications CPC, COC, RHIT, RHIA, CCS or CCS-P required; CPMA, CHC or CPCO preferred.
• 5+ years combined experience in coding, billing, documentation improvement, clinical practice, payer claims adjudication, and/or compliance; 2–3 years in medical auditing/review.

Mansioni

• Conduct medical audit reviews and analyses of clinical/technical records to support compliant billing practices.
• Identify opportunities for improvement in billing and documentation processes.
• Prepare reports and executive summaries; partner with leadership to drive process improvements and ongoing compliance.

Conoscenze

Medical billing

Medical coding

Auditing

Regulatory compliance

Formazione

High school diploma

Medical billing/coding coursework

CPC/COC/RHIT/RHIA/CCS/CCS-P

CPMA/CHC/CPCO preferred

Descrizione del lavoro

Description

Regulatory Billing Auditor(100% Remote)

The Regulatory Billing Auditorsupports compliant charging, billing, and documentation practices across the MaineHealth system by conducting medical audit reviews and analyses of clinical and technical records. Working under the direction of the Regulatory Billing Audit Manager, this role evaluates billing and documentation processes, identifies opportunities for improvement, and helps ensure compliance with healthcare regulations and organizational standards.

This position develops expertise in regulatory billing, including outpatient and physician practice billing, while partnering with Regulatory Billing leadership and Senior Billing Auditors to expand knowledge across a broad range of audit activities. The Auditor analyzes findings, prepares reports and executive summaries, and collaborates with leaders and staff to support process improvements, education, and ongoing compliance efforts.

Why This Role Stands Out

• Develop expertise in healthcare regulatory billing and auditing within a large integrated health system.
• Partner with experienced auditors and revenue cycle professionals who are committed to collaboration and continuous learning.
• Contribute to meaningful work that supports compliance, operational excellence, and revenue integrity.
• Gain exposure to a variety of auditing activities, including clinical and technical billing reviews.
• Enjoy the flexibility of afully remoteposition while remaining connected to a supportive and engaged team.

Why MaineHealth?

• Join Maine's largest integrated health system and help advance our mission of improving the health of the communities we serve.
• Work in a culture that values teamwork, innovation, and professional development.
• Support initiatives that strengthen compliance, improve processes, and enhance the patient experience.
• Build your career with an organization committed to employee growth and success.

Required Minimum Knowledge, Skills, and Abilities (KSAs)

1. Education: HS Education required. Secondary coursework in medical billing and coding is preferred.
2. License/Certification: Must Possess one or more of the following certifications: CPC, COC, RHIT, RHIA, CCS, or CCS-P. Additional certifications including CPMA, CHC, or CPCO are preferred.
3. Experience: Five or more years combined experience in coding, billing, documentation improvement, clinical practice, payer claims adjudication, and/or compliance Two to three years' experience with medical auditing, research, and chart review is necessary.

#LI-Remote

Additional Information

MaineHealth is committed to fostering a supportive, inclusive environment where care team members can thrive while making a meaningful impact in the communities we serve across Maine and New Hampshire. We offer competitive benefits including paid parental leave, flexible work options, student loan assistance, professional development opportunities, and well-being resources-so you can grow your career while feeling supported both personally and professionally.

We recognize the value each team member brings to our organization.Any offer of employmentwill depend onqualificationssuch asskills, relevant experience, education, certifications,and otherjob-relatedfactors. Thebase rangeis an estimate and does notreflect the full valueofourtotal compensationpackage.

The pay range for this position is $66,123.20to $89,481.60per year.

Compensation for part-time positions isdeterminedon a prorated basis consistent with the scheduled hours and applicable full-time equivalent (FTE).

In addition to base pay, MaineHealth offerscomprehensivebenefits, recognition programs, career growth opportunities, and,where applicable,shiftdifferentials or other incentives.

If you have questions about this role, please contact [e-mail]

Notice Regarding Maine Employer Surveillance Statute:

Pursuant to Maine's Employer Surveillance Statute, prospective care team members are notified that MaineHealth may monitor, collect, record, review, or retain information related to the use of its systems, networks, applications, files, data, communications platforms (including notified recordings), smart badges, building access, company vehicle GPS data, business calls, and workplace security cameras.

Information collected may be used for legitimate business purposes, including security, safety, compliance, investigations, training, quality assurance, and operational management.