Senior Healthcare Compliance Officer, Revenue Cycle Management

Job Description: • Designs, implements, and manages the organization's revenue cycle compliance program. This includes creating and updating policies and procedures related to patient billing, coding, and documentation. • Conducts regular risk assessments to identify potential vulnerabilities within the revenue cycle. • Oversees and conducts internal audits of billing records and medical documentation to ensure compliance with payer requirements, such as Medicare, Medicaid, and private insurers. • Develops and delivers compliance training programs for staff, including billing and coding specialists, as well as clinical and administrative teams. • Investigates reported or discovered compliance issues, documenting findings, and reporting potential violations to leadership. • Acts as the primary liaison with external regulatory bodies and government agencies, responding to inquiries, audits, and investigations. • Develops and tracks corrective action plans to address compliance deficiencies, following up with management to ensure successful implementation. • Creates and presents periodic compliance reports to leadership detailing auditing activities, findings, risk levels, and the status of corrective actions. Requirements: • A bachelor's degree in a related field such as business administration, finance, or healthcare management is often preferred, but not always required. • In-depth knowledge of healthcare regulations and laws, including HIPAA, CMS guidelines, and state-specific billing requirements. • Advanced knowledge of medical coding, including CPT, HCPCS, and ICD-10. • The ability to analyze complex data sets from audits and financial reports to identify trends, pinpoint issues, and generate actionable insights. • Excellent written and verbal communication to explain complex regulatory information, create clear policies, and report findings to various stakeholders, from billing staff to senior leadership. • The ability to lead teams and influence cross-functional departments to adopt and maintain a culture of compliance. • A keen eye for detail is essential for reviewing documentation, policies, and regulations to ensure all requirements are met. Benefits: • Flexible work arrangements • Professional development opportunities Apply tot his job Apply To this Job