Remote Billing Compliance Lead: Audit & Data Insights

Saint Francis Hospital, Inc.; United States; Remote; USD 90,000 - 120,000; Full time

Job summary

Saint Francis Hospital, Inc. is seeking a Senior Billing Compliance Analyst to support the system’s billing compliance program.

The role involves audits, data analytics, and leading prevention strategies in collaboration with compliance, coding, revenue cycle, and clinical teams. The candidate should have 5+ years in healthcare billing, coding, or compliance, and expertise in ICD-10-CM, CPT, HCPCS, CMS guidelines, and Epic systems.

Qualifications

• Advanced knowledge of ICD-10-CM, CPT, HCPCS, and billing regulations.
• Understanding CMS guidelines and OIG work plan focus areas.
• Experience with Epic and charging workflows.

Responsibilities

• Conducts and manages hospital and professional billing compliance audits, reviews, projects and investigations.
• Ensures reports are organized, accurate, and professional in content and presentation.
• Identifies significant issues within audit scope ensuring compliant billing practices.
• Develops ongoing billing compliance training and awareness initiatives.
• Monitors regulatory developments and analyzes related publications.
• Develops billing compliance documents with stakeholder input and approvals.
• Analyzes data to identify risks and draw conclusions from audits and investigations.
• Manages Billing Compliance Program policy and procedures lifecycle.

Skills

ICD-10-CM CPT HCPCS

CMS guidelines

OIG focus areas

Epic knowledge

Data analysis

Communication skills

Education

Bachelor's degree in Business, Healthcare Administration, or Health Information Management

Tools

Epic

Charge router

Microsoft 365

Job description

Saint Francis Hospital, Inc. is seeking a Senior Billing Compliance Analyst to support the system’s billing compliance program.

The role involves audits, data analytics, and leading prevention strategies in collaboration with compliance, coding, revenue cycle, and clinical teams. The candidate should have 5+ years in healthcare billing, coding, or compliance, and expertise in ICD-10-CM, CPT, HCPCS, CMS guidelines, and Epic systems.