Senior HIM Audit Lead - Compliance & Reimbursement

Anna Jaques Hospital; Boston, Northern (MA, KY); Hybrid; USD 29,000 - 39,000; Full time

Job summary

Beth Israel Lahey Health (BILH) seeks a Lead Health Information Management Audit Specialist to oversee third‑party audits, ensure accurate billing, and support compliance across BILH and affiliates. Under supervision, you will train staff, monitor productivity, review medical record documentation, and coordinate audit appeals with a focus on regulatory requirements and proper release of information.

The role requires collaboration with physicians, coding, billing, and case management teams to

Qualifications

• Clinical background (RN or LPN) and/or HIM degree/coding certification strongly preferred.
• 3–5 years healthcare experience required.
• Knowledge of medical terminology, anatomy & physiology, and general coding guidelines.
• Experience using EHR, Microsoft Word and Excel.
• Excellent oral and written communication skills; ability to manage multiple projects.

Responsibilities

• Assists the manager of the audit in planning and evaluating procedures that support HIM and BILH audit goals.
• Prepare and report the status and outcome of Audit & Compliance components.
• Serve as central audit resource to support requirements and follow-up.
• Oversee adherence to standards for audits and reviews to ensure appropriate release of information.
• Collaborate with Director of HIM and Audit Manager on regulatory issues.
• Assist in assignment of tasks and resolving technical & operational problems.
• Lead and assist with audits for CMS, CERT, RACs, ADR, Quality, DRG submissions, etc.
• Research cases, transfer docs to electronic media, update intra-department database, communicate findings.
• Coordinate audit appeals and reporting for tracking, financials, and risk.
• Coordinate audits using Cobius Health for tracking and support workflows.
• Review billing/claims data in Epic; advise on non-compliant coding.
• System administrator for audit tracking system.
• Prepare reporting graphics and PowerPoint presentations.
• Train auditors on navigation of Epic, ECMS/Documentum.

Skills

Medical terminology

Anatomy & physiology

Coding guidelines

EHR experience

MS Word & Excel

Education

HIM degree

Coding certification

RN/LPN background

Tools

Epic

Cobius Health

ECMS/Documentum

Job description

Beth Israel Lahey Health (BILH) seeks a Lead Health Information Management Audit Specialist to oversee third‑party audits, ensure accurate billing, and support compliance across BILH and affiliates. Under supervision, you will train staff, monitor productivity, review medical record documentation, and coordinate audit appeals with a focus on regulatory requirements and proper release of information.

The role requires collaboration with physicians, coding, billing, and case management teams to