Top 73 Healthcare compliance Jobs in Massachusetts

Coding and Compliance Auditor
South Shore Health —Weymouth, MA
- $73,000 - $104,400 a year
- Full-time
- Hybrid work
- 5 years
- Mid-level
- Acute care experience
Associate Executive Director - Corporate Compliance Officer
North Charles Mental Health Research and Training Foundation, Inc —Cambridge, MA
- $73,000 - $80,000 a year
- Full-time
- HIPAA
- Office
- Master's degree
- Health savings account
- Health insurance
Quick Apply
Compliance Director
The Confidential Search Company —Dorchester, MA
- Up to $180,000 a year
- Full-time
- Hybrid work
- 5 years
- Master's degree
- Bachelor's degree
- Health insurance
- Dental insurance
Quick Apply
Program Integrity Clinical Compliance Auditor
Optum —Boston, MA
- $29 - $52 an hour
- 8 hour shift
- Remote
- 18 years or older
- RN License
- Customer service
- On-the-job training
Coding Compliance Analyst
Optum —Worcester, MA
- $23.89 - $42.69 an hour
- 8 hour shift
- Remote
- Pass drug screening
- Mid-level
- High school diploma or GED
- AD&D insurance
- Employee stock purchase plan
Billing Compliance Reviewer
Dana-Farber Cancer Institute —Brookline, MA
- $93,800 - $106,000 a year
- Full-time
- 5 years
- Mid-level
- High school diploma or GED
Sr Regulatory Affairs Specialist
Cardinal Health —Mansfield, MA
- $66,500 - $88,020 a year
- Remote
- Mid-level
- Bachelor's degree
- No degree
- Paid parental leave
- Health savings account
Analyst, Medicare Compliance
Blue Cross Blue Shield of Massachusetts —Hingham, MA
- $72,630 - $88,770 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- Health insurance
- Dental insurance
2d
Healthcare Compliance Operations Manager/ Senior Manager
Ionis Pharmaceuticals, Inc. —Boston, MA
- $72,800 - $129,967 a year
- Remote
- Analysis skills
- Bachelor's degree
- Travel
Quick Apply
2d
Compliance and Privacy Specialist
Beth Israel Lahey Health —Charlestown, MA
- $70,000 - $90,000 a year
- Full-time
- Microsoft Outlook
- Hospital
- HIPAA
4d
Director of Compliance
Codman Square Health Center Inc —Boston, MA
- $114,000 - $177,000 a year
- Master's degree
- Human resources
- Ability to sit for extended periods
- Commuter assistance
- AD&D insurance
Quick Apply
12d
Lead Director, Network Compliance & Regulator - Northeast
CVS Health —Boston, MA
- $100,000 - $231,540 a year
- Full-time
- Hybrid work
- Microsoft Excel
- Office
- 3 years
- Health insurance
- Dental insurance
11d
Manger, Transplant Quality & Regulatory Compliance
Beth Israel Lahey Health —Boston, MA
- $120,000 - $150,000 a year
- Full-time
- Hospital
- 5 years
- English
Director of Compliance & Regulatory Affairs (State of MA)
Regard Healthcare —Cummington, MA
- $100,000 - $140,000 a year
- Hybrid work
- Addiction Medicine
- Residential
- Master's degree
Quick Apply
11d
Senior Billing Compliance Hospital Reviewer
Dana-Farber Cancer Institute —Boston, MA
- $116,700 - $132,000 a year
- Full-time
- Microsoft Office
- High school diploma or GED
- Bachelor's degree
Billing Compliance Curriculum Development Specialist
Dana-Farber Cancer Institute —Boston, MA
- $83,400 - $91,100 a year
- Full-time
- Microsoft Excel
- 5 years
- Mid-level
Director Billing Compliance
Dana-Farber Cancer Institute —Brookline, MA
- $154,200 - $170,800 a year
- Full-time
- HIPAA
- Master's degree
- Bachelor's degree
Compliance Reporting Program Manager
Cohere Health —Boston, MA
- $110,000 - $125,000 a year
- Remote
- 8 years
- SQL
- Analysis skills
- Paid parental leave
- Health savings account
Quick Apply
Life Safety and EOC Compliance Manager
Newton-Wellesley Hospital —Newton, MA
- $79,560.00 - $115,720.80 a year
- Full-time
- Hospital
- 5 years
- Bachelor's degree
- Opportunities for advancement
Quick Apply
Regional Compliance Manager (Hybrid - Marlborough, MA)
Quest Diagnostics —Marlborough, MA
- $110,000 - $125,000 a year
- Full-time
- Management
- Bachelor of Science
- Analysis skills
- Employee stock purchase plan
- Disability insurance
Quick Apply
5d

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healthcare compliance jobs near massachusetts

Coding and Compliance Auditor

South Shore Health -
Weymouth, MA

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Job Details

Full-time
$73,000 - $104,400 a year

Qualifications

Medical coding experience in outpatient clinics
Medical coding for surgical records
Health information management
Acute care experience

Full Job Description

Job Description Summary

The Coding & Compliance Auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, and designs and delivers coding education and training programs for clinical staff, coders and other key stakeholders. The Coding & Compliance Auditor monitors external regulatory and internal process changes and provides support to colleagues in adhering to Federal, State and local requirements. This is a hybrid position: 2 days onsite; 3 days remote option.

Job Description

Job Responsibilities:

Establishes, implements, and maintains a formalized review process for coding compliance, including a formal review (audit) process.

Responsible for conducting both routine and targeted audits to ensure clinical documentation supports accurate CPT, HCPC’s, PCS and ICD-10-CM codes.
Perform prospective and retrospective audits to validate medical necessity and documentation supportive of code selection.
Analyzes data to identify deficiencies, prepare reports to deliver provider education specific to training needs identified during audit.
Develop and monitor follow-up audits and education as determined necessary to improve documentation quality.

Support all departments of the Health System with coding guidance:

Pertaining to compliance training / education as requested from providers and/or staff related to coding, billing and documentation in the inpatient, outpatient, professional, surgical and Home Health divisions of the Health System to ensure accuracy and support program objectives.
Designs training programs around compliant coding and billing from a regulatory standpoint for any new initiatives or programs affecting the Health System.
Evaluates vendor-training materials for its application or recommendation for use in educational programs.

Maintains:

Knowledge of all State and Federal regulatory changes that impact the Health System
Revises/modifies any instructional tools as necessary based on any changes to State and Federal regulatory changes to ensure guidance and training are accurate.
Assists in the development of follow-up mechanisms to ensure that knowledge and/or skills learned in the training are being applied on the job and have an impact on staff performance in meeting organizational goals.
Reports on program effectiveness and documents necessary changes.

Self Development:

Participates in professional societies or organizations relevant to ICD-9-CM, ICD-10-CM, PCS and CPT.
Maintains necessary licensure required for employment.

Administrative Duties:

Assists with administering programs as assigned.
Attends and participates in organization-wide committees as assigned.
Performs additional related duties as required.
Designs, develops and delivers education and training programs that meet the staff’s needs for compliant coding and billing.
Plans and develops curriculum in accordance with the organization’s strategic goals, mission and business strategies to improve employee performance leading to quality data and accuracy.

JOB REQUIREMENTS

Minimum Education - Preferred

Associates or Bachelor’s degree in Health Information Management.

Minimum Work Experience

Minimum 5 years acute care coding with demonstrated expertise in ICD-9-CM, ICD-10-CM, PCS and CPT coding.
Experience, preferred, in adult and continuing education, organizational development and training.

Required Certifications

CCA - Certified Coding Associate (AHIMA-American Health Information Management Assoc) or

CCS - Certified Coding Specialist (AHIMA-American Health Information Management Assoc) or

CCS-P - Certified Coding Specialist-Physican Based (AHIMA-American Health Information Management Assoc) or

CPC - Certified Professional Coder (AAPC-American Academy of Professional Coders) or

CPMA -Certified Professional Medical Auditor (AAPC-Academy of Professional Coders) or

RHIA - Registered Health Information Administrator (AHIMA-American Health Information Management Association)

Required additional Knowledge and Abilities:

Interact with constituents who have competing priorities and effectively communicate the importance of compliance in a respectful yet authoritative manner.

Apply Now

Refine Your Search

healthcare compliance jobs in massachusetts

Coding and Compliance Auditor

Associate Executive Director - Corporate Compliance Officer

Compliance Director

Program Integrity Clinical Compliance Auditor

Coding Compliance Analyst

Billing Compliance Reviewer

Sr Regulatory Affairs Specialist

Analyst, Medicare Compliance

Healthcare Compliance Operations Manager/ Senior Manager

Compliance and Privacy Specialist

Director of Compliance

Lead Director, Network Compliance & Regulator - Northeast

Manger, Transplant Quality & Regulatory Compliance

Director of Compliance & Regulatory Affairs (State of MA)

Senior Billing Compliance Hospital Reviewer

Billing Compliance Curriculum Development Specialist

Director Billing Compliance

Compliance Reporting Program Manager

Life Safety and EOC Compliance Manager

Regional Compliance Manager (Hybrid - Marlborough, MA)

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