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Senior Hospital Billing Compliance Auditor Job in Boston, Massachusetts

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Job Title: Senior Hospital Billing Compliance Auditor

Employer:Boston Children's Hospital
Required Certifications:CPC,CCS-P
Required Experience:3 to 4 years
Location: Boston 02115, MA, US
Date Posted:7/10/2020
This Senior Hospital Billing Compliance Auditor will be responsible for:
  • Performing audits for hospital billing compliance by reviewing medical record documentation for documentation compliance for billed CPT, Level II HCPCS and ICD-10 diagnosis codes.
  • Determining that governmental and third party payer regulations are being complied with as evidenced in medical record documentation; and evaluating appropriateness of billing and coding procedures.
  • Utilizing audit software to perform hospital billing compliance audits.
  • Preparing audit reports and performing follow up education to clinical Departments 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.
  • Working with clinical Departments on hospital billing compliance initiatives.
  • Assisting in response to billing audit requests from outside the institution (e.g., government audits).

To qualify, you must have:
  • A minimum of three (3) years’ experience working in Hospital coding and billing, including assisting Hospital Departments to comply with regulatory CPT and ICD-10 coding requirements.
  • A Bachelor’s Degree is preferred however not required.
  • Knowledge of healthcare compliance regulations.
  • The ability to read and understand medical record documentation.
  • The 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.
  • Communication and collaboration skills in order to effectively deal with conflicting views or issues and mediate fair solutions, and well-developed writing skills.
  • A Professional Billing Coding certification (CPC, CCS-P) required.?

Boston Children’s Hospital offers competitive compensation and unmatched benefits, including a flexible schedule, affordable health, vision and dental insurance, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition Reimbursement, and discounted rates on T-passes. 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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