Senior Billing Compliance Auditor (Hybrid)

Boston Children's Hospital; Boston (MA); Hybrid; USD 75,000 - 95,000; Full time

Benefits offered by this job

Flexible schedules

Health insurance

Pension / retirement plan

Tuition and certification reimburse

Job summary

Boston Children's Hospital is seeking a Billing Compliance Auditor III (hybrid) to audit clinical documentation and coding for regulatory compliance. The role involves analyzing medical records and billing records, preparing reports, and advising physicians and departments on improvements.

The position requires CPC/CCS-P certification and 3 years CPT/ICD-10 coding experience, including reviewing physician documentation.

Qualifications

• High School Diploma/GED required.
• Associates Degree or Bachelors Degree preferred.
• Professional Billing Coding certification (CPC, CCS-P) required.
• 3 years CPT and ICD-10 coding experience, including some physician documentation review.

Responsibilities

• Audit clinical documentation, physician billing and payment records for regulatory compliance.
• Prepare reports and provide training to physicians and staff based on audit results.
• Develop and draft billing and coding policies in coordination with Hospital leadership.
• Respond to external billing audits and support government or payer audits.

Skills

CPT coding

ICD-10 coding

Auditing skills

Reporting & training

Education

High School Diploma/GED

Associates or Bachelors preferred

Job description

Boston Children's Hospital is seeking a Billing Compliance Auditor III (hybrid) to audit clinical documentation and coding for regulatory compliance. The role involves analyzing medical records and billing records, preparing reports, and advising physicians and departments on improvements.

The position requires CPC/CCS-P certification and 3 years CPT/ICD-10 coding experience, including reviewing physician documentation.