Senior Hospital Billing Compliance Lead

Northwestern Medicine; Chicago (IL); On-site; USD 90,000 - 120,000; Full time

Job summary

Northwestern Medicine in Chicago seeks a Senior Compliance Associate for Hospital Billing to support the Corporate Compliance Program, respond to inquiries, and lead investigations related to inpatient billing and coding compliance.

You will coordinate regulatory inquiries with CMS and other agencies, monitor risks across the health system, help develop policies, and track metrics to ensure adherence to state and federal requirements while maintaining confidentiality and professionalism.

Qualifications

• Healthcare experience related to hospital inpatient services, including compliance, regulatory, legal, coding or billing.
• Proficiency with Microsoft Office applications (Word, Excel, PowerPoint, Access).
• Strong written, verbal, and interpersonal skills with stakeholders at all levels.

Responsibilities

• Respond to hospital billing compliance inquiries via multiple reporting mechanisms and document resolutions.
• Conduct and support investigations related to hospital billing, identifying root causes and recommending actions.
• Lead reviews of hospital billing and inpatient services for billing accuracy and regulatory adherence.
• Coordinate regulatory inquiries, audits, and investigations with CMS, OIG, and state agencies.
• Assist with medical record and claim reviews and quality assurance of clinical documentation.
• Identify and monitor healthcare compliance risks across the health system.
• Stay current on regulatory trends affecting the health system and subsidiaries.
• Assist with the development and implementation of the annual Compliance Work Plan.
• Help create and maintain compliance policies and procedures; provide guidance to departments.
• Coordinate agendas and materials for compliance-related committees and meetings.
• Help develop department metrics to monitor compliance with rules and regulations.

Skills

Communication

Analytical skills

Regulatory knowledge

Education

Bachelor’s degree in a relevant field

Certified coder (RHIA, RHIT, CCS, CCS-P) or eligible

Tools

Microsoft Office

Job description

Northwestern Medicine in Chicago seeks a Senior Compliance Associate for Hospital Billing to support the Corporate Compliance Program, respond to inquiries, and lead investigations related to inpatient billing and coding compliance.

You will coordinate regulatory inquiries with CMS and other agencies, monitor risks across the health system, help develop policies, and track metrics to ensure adherence to state and federal requirements while maintaining confidentiality and professionalism.