Remote Regulatory Billing Auditor — Healthcare Compliance

MaineHealth; Westbrook (ME); Remote; USD 66,000 - 89,000; Full time

Benefits offered by this job

Competitive benefits

Professional development opportunities

Well-being resources

Flexible work options

Job summary

MaineHealth is seeking a Regulatory Billing Auditor (100% remote) to conduct audit reviews and analyses of clinical and technical records across the system. You will evaluate billing processes, identify opportunities for improvement, and help ensure compliance with healthcare regulations and organizational standards.

The role develops expertise in outpatient and physician practice billing, working with Regulatory Billing leadership to expand knowledge and audit activities.

Qualifications

• HS diploma required; medical billing and coding coursework preferred.
• Must possess one or more of the listed certifications: CPC, COC, RHIT, RHIA, CCS or CCS-P; CPMA, CHC, CPCO preferred.
• 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.

Responsibilities

• Conduct medical audit reviews and analyses of clinical and technical records.
• Evaluate billing and documentation processes; identify improvement opportunities.
• Prepare reports and executive summaries; support process improvements and ongoing compliance.
• Collaborate with leadership and staff to promote education and ongoing compliance.

Skills

Regulatory billing auditing

Medical coding

Analytical skills

Attention to detail

Education

High School Diploma

Billing and coding coursework

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

CPMA/CHC/CPCO certifications preferred

Job description

MaineHealth is seeking a Regulatory Billing Auditor (100% remote) to conduct audit reviews and analyses of clinical and technical records across the system. You will evaluate billing processes, identify opportunities for improvement, and help ensure compliance with healthcare regulations and organizational standards.

The role develops expertise in outpatient and physician practice billing, working with Regulatory Billing leadership to expand knowledge and audit activities.