New

Billing Compliance Auditor/Educator

Brigham and Women's Hospital
United States, Massachusetts, Boston
801 Massachusetts Avenue (Show on map)
Mar 25, 2025
Responsible to assess organization risk through the review of clinical documentation, billing claims data and revenue cycle workflows. Deliver feedback and education to clinical and revenue cycle departments through written and face to face communications, including individual and group training. Essential Functions Audit and analyze the documentation accuracy, medical necessity and billing code selection of clinical and billing providers in alignment with CMS, OIG and other applicable professional services regulations and guidelines. Prepare audits, reports and educational content as necessary. Effectively monitor and report detailed feedback to appropriate clinical and administrative providers. Design and deliver provider training to clinical caregivers and administrative staff on the rules and regulations related to billing compliance and coding, including findings related to audits. Assist in the development of new compliance guidelines, procedures, and training programs designed to enhance the effectiveness of the department. Associate's Degree Business Administration required. Bachelor's Degree Business Administration preferred 1-2 years required in billing, audit, medical records coding experience Knowledge, Skills & Abilities Ability to problem solve and trouble shoot independently. Advanced understanding and use of medical terminology. Understand clinical workflows and concerns in a variety of healthcare business areas. Advanced comprehension of billing and fiscal information. Advanced computer skills. Strong attention to detail. Physical Requirements Standing Occasionally (3-33%) Walking Occasionally (3-33%) Sitting Constantly (67-100%) Lifting Occasionally (3-33%) 20lbs - 35lbs Carrying Occasionally (3-33%) 20lbs - 35lbs Pushing Rarely (Less than 2%) Pulling Rarely (Less than 2%) Climbing Rarely (Less than 2%) Balancing Occasionally (3-33%) Stooping Occasionally (3-33%) Kneeling Rarely (Less than 2%) Crouching Rarely (Less than 2%) Crawling Rarely (Less than 2%) Reaching Occasionally (3-33%) Gross Manipulation (Handling) Constantly (67-100%) Fine Manipulation (Fingering) Frequently (34-66%) Feeling Constantly (67-100%) Foot Use Rarely (Less than 2%) Vision - Far Constantly (67-100%) Vision - Near Constantly (67-100%) Talking Constantly (67-100%) Hearing Constantly (67-100%) The Brigham and Women's Hospital, Inc. is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.