Overview:
The Compliance Specialist- Billing supports the development and implementation of our compliance program, policies, reporting, and practices. In-depth knowledge of billing regulations, experience with auditing, and strong analytical skills are crucial for this role. The role will focus on billing compliance, documentation improvement, and policy and procedure management. Creates and utilizes existing internal controls and billing systems to identify, detect, and correct noncompliance. Prepares and updates education materials. Assists with training initiatives that inform stakeholders about billing compliance requirements. This position reports to the Corporate Compliance and Privacy Officer. Ultimately, the role of a Billing Compliance Specialist is to maintain the integrity of our billing process and to ensure accurate, legal, and compliant billing practices.

Responsibilities:

• Interpersonal skills to work effectively within a team environment and maintain positive relationships with colleagues to ensure appropriate risk mitigation strategies are in place.
• Good communication skills to coordinate with healthcare providers and insurance companies to resolve any discrepancies or issues.
• Proven experience as a Billing Compliance Specialist, Billing Coordinator or similar role
• Strong knowledge of medical billing processes, healthcare insurance, regulatory compliance, and coding practices to ensure accurate and compliant billing.
• Strong knowledge of data analysis and audit procedures is needed to examine patient bills for accuracy and adherence to billing codes.
• Outstanding communication and presentation skills to educate and guide staff on billing compliance matters
• Exceptional attention to detail to review and verify billing data for accuracy, completeness, and compliance with regulations and procedures.
• Excellent organizational and multitasking abilities
• Problem solver who can quickly identify billing discrepancies and develop solutions.
• Experience with healthcare billing software and electronic health record systems to perform job duties efficiently and effectively

Qualifications:

• 3-5 years of experience in a billing compliance role, preferably in the dialysis sector.
• A bachelor’s degree in finance, business administration, accounting or a related field.
• Certification Requirement: A coding certification (e.g., CPC, CCS, or equivalent) is required for this role. However, candidates who demonstrate strong foundational knowledge and relevant experience may be considered for hire with the expectation that certification will be obtained within [6 months] of employment.

• Interpersonal skills to work effectively within a team environment and maintain positive relationships with colleagues to ensure appropriate risk mitigation strategies are in place.
• Good communication skills to coordinate with healthcare providers and insurance companies to resolve any discrepancies or issues.
• Proven experience as a Billing Compliance Specialist, Billing Coordinator or similar role
• Strong knowledge of medical billing processes, healthcare insurance, regulatory compliance, and coding practices to ensure accurate and compliant billing.
• Strong knowledge of data analysis and audit procedures is needed to examine patient bills for accuracy and adherence to billing codes.
• Outstanding communication and presentation skills to educate and guide staff on billing compliance matters
• Exceptional attention to detail to review and verify billing data for accuracy, completeness, and compliance with regulations and procedures.
• Excellent organizational and multitasking abilities
• Problem solver who can quickly identify billing discrepancies and develop solutions.
• Experience with healthcare billing software and electronic health record systems to perform job duties efficiently and effectivel