Compliance Officer - Medical Billing & RCM

We are seeking an experienced Medical Billing Compliance Officer to oversee and strengthen compliance practices for a behavioral healthcare billing company that provides third-party billing and RCM services through an EMR platform. The ideal candidate will have direct experience ensuring compliance for medical billing companies handling behavioral health clients, including ABA and mental health providers. This role involves reviewing claim workflows, verifying adherence to payer and regulatory requirements, and ensuring the company’s billing operations meet federal, state, and contractual compliance standards. Responsibilities - Oversee compliance practices for third-party billing operations supporting multiple behavioral health clients - Review claim submissions, documentation, and denial patterns for payer and regulatory compliance - Develop and maintain written compliance policies, audit checklists, and training programs for billing staff - Perform periodic internal and external audits to identify potential risks or improper billing activity - Provide corrective action plans and guide management on remediation steps - Ensure compliance with HIPAA, OIG, CMS, and payer-specific requirements - Monitor regulatory changes and update company policies and procedures accordingly Qualifications - Minimum five years of experience in medical billing compliance, ideally for a third-party billing or RCM company - Strong knowledge of HIPAA, CMS, OIG, and payer compliance standards - Experience with ABA or mental health billing strongly preferred - Compliance certification such as CHC, CPCO, or equivalent preferred - Excellent written communication, documentation, and training skills - Familiarity with EMR, clearinghouses, and payer portals Apply tot his job Apply To this Job