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Billing Compliance Education Manager Job in Boston, Massachusetts

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Job Title: Billing Compliance Education Manager

Employer:Boston Children's Hospital
Required Certifications:CPC,CCS-P
Required Experience:3 to 4 years
Preferred Experience:3 to 4 years
Location: Boston 02215, MA, US
Date Posted:2/10/2021
At Boston Children’s Hospital, success is measured in patients treated, parents comforted and teams taught. It’s in discoveries made, processes perfected, and technology advanced. In major medical breakthroughs and small acts of kindness. And in colleagues who have your back and patients who have your heart. As a teaching hospital of Harvard Medical School, our reach is global and our impact is profound. Join our acclaimed Office of General Counsel and discover how your talents can change lives. Yours included.

Billing Compliance Education Manager will be responsible for:
  • Performing audits of clinical documentation, physician billing and payment records and applicable industry standard codes by analyzing medical records, coding records and health system bills validating clinical documentation in conjunction with the bill.
  • Assessing the level and accuracy of coding, determining that governmental and third party payer regulations are being complied with; and evaluating appropriateness of billing and coding procedures
  • Preparing reports and providing individual and/or group instruction to physicians and others based on results of audit.
  • Working collaboratively with appropriate personnel to identify and recommend strategies for process improvement and to develop and draft billing and coding policies for the CHB Foundations in coordination with the Hospital
  • Assisting in response to billing audit requests from outside the institution (e.g., government audits, payer audits).
To qualify, you must have:
  • A Bachelor’s degree in Health Information Management or Nursing and 3+ years of experience reviewing physician documentation and assisting physicians to meet government and other third party payer and CPT and ICD9 coding requirements through individual and group training sessions.
  • The knowledge of healthcare compliance regulations and possess a focused experience in one or more medical specialties is a plus.
  • Strong analytical skills to collect information from diverse sources, apply professional principles in performing various analyses, and summarize the information and data in order to solve problems OR design relatively complex systems and programs that cross department/divisional lines.
  • Excellent communication skills in order to effectively deal with conflicting views or issues and mediate fair solutions, and well-developed writing skills. Professional Billing Coding certification (CPC, CCS-P) required.

Please note:  During a public health emergency, individuals in this role may be expected to take on additional duties to respond to organization needs.

Boston Children’s Hospital offers competitive compensation and unmatched benefits, including affordable health, vision and dental insurance, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition Reimbursement, cell phone plan discounts and discounted rates on T-passes (50% off). Discover your best.

Boston Children’s Hospital is an Equal Opportunity / Affirmative Action Employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, sex, sexual orientation, gender identity, protected veteran status or disability.


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