Provides advanced support to the health system’s billing compliance program by performing complex audits.
Leads data analytics activities and guides prevention and monitoring strategies.
Serves as a subject matter expert on billing, charging, and coding compliance.
Collaborates with operational leaders, compliance leadership, and clinical departments.
Identifies systemic risk areas and supports investigations.
Develops training content and advises on regulatory changes.

Minimum 5 years of experience in Healthcare Billing, Coding, or Compliance.
Audit Process and Data Analysis experience, preferred.
Advanced knowledge of ICD-10-CM, CPT, and HCPCS coding systems, guidelines, and regulations.
Strong understanding of CMS billing guidelines and OIG work plan focus areas.
Advanced knowledge of Epic, charge router logic, clinical workflows, and charging methodologies.
Knowledge of Microsoft 365 and other applicable software.
Excellent communication skills, both written and verbal.
Ability to present complex information to leadership.
Strong data analysis capabilities, including large datasets and root-cause analysis.

Senior Billing Compliance Analyst

Key skills