Senior Billing Compliance Analyst

Job description

Accountabilities: Lead and manage complex hospital and professional billing compliance audits, reviews, investigations, and special projects, ensuring findings are accurate, well-supported, and aligned with applicable regulations. Analyze billing, coding, charging, and operational data to identify compliance risks, systemic issues, trends, and root causes, using audit results and investigations to develop actionable recommendations. Evaluate compliance with federal and state regulations, CMS billing requirements, OIG focus areas, payer-specific policies, and applicable coding guidelines. Serve as a billing compliance subject matter expert, advising operational leaders, compliance teams, coding departments, revenue cycle stakeholders, and clinical functions on appropriate billing and charging practices. Develop and maintain billing compliance training, awareness initiatives, policies, procedures, and implementation guidance based on emerging regulatory requirements and identified risks. Monitor regulatory developments, healthcare industry publications, government resources, and other authoritative sources to assess their potential impact on billing operations. Manage the billing compliance policy and procedure lifecycle, incorporating stakeholder feedback and recommending updates, best practices, and process improvements. Prepare clear, professional audit reports, correspondence, executive-level summaries, and other compliance documentation that effectively communicate complex findings and recommendations. Present audit conclusions, risk assessments, and recommendations to leadership and collaborate with stakeholders to support remediation and sustainable compliance improvements. Exercise independent judgment when addressing non-routine compliance issues while coordinating the work of colleagues and cross-functional partners without direct supervisory responsibility. Requirements: Minimum of 5 years of experience in healthcare billing, coding, or compliance, with recent 3–5 years of Epic HB or PB Billing Compliance experience required. High school diploma or GED required; a bachelor’s degree in Business, Healthcare Administration, Health Information Management, or a related field is preferred. Certified Healthcare Compliance (CHC) certification is preferred but not required. Advanced knowledge of ICD-10-CM, CPT, and HCPCS coding systems, coding guidelines, and federal and state healthcare billing regulations. Strong understanding of CMS billing guidelines, OIG Work Plan focus areas, payer-specific requirements, and healthcare regulatory environments. Advanced knowledge of Epic, including charge router logic, clinical workflows, charging methodologies, and billing processes. Demonstrated experience conducting compliance audits, investigations, data analysis, and risk assessments, preferably involving large and complex datasets. Strong analytical capabilities, including financial analysis, root-cause analysis, audit test work, and the ability to translate data into meaningful compliance conclusions. Excellent written and verbal communication skills, with the ability to explain complex regulatory and analytical information clearly to executives, directors, and other stakeholders. Strong presentation, organization, project management, and stakeholder collaboration skills, with the ability to manage multiple priorities independently. Proficiency with Microsoft 365 and other relevant business and analytical software. Ability to work effectively with healthcare professionals, operational teams, internal customers, and senior leadership in a collaborative environment. Benefits: Remote work opportunity based in Oklahoma, United States. Competitive compensation aligned with experience, qualifications, and job-related factors. Opportunity to work in a senior, highly visible billing compliance role with frequent interaction with Director-level and above stakeholders. Meaningful opportunity to influence healthcare billing compliance, risk management, training, and process improvement. Collaborative environment involving compliance, revenue cycle, coding, clinical, and operational teams. Opportunity to apply advanced analytics and healthcare compliance expertise to complex organizational challenges. Equal opportunity workplace with reasonable accommodations available for qualified individuals with disabilities. Benefits and other employment offerings may apply based on eligibility and organizational policies. How Jobgether works: We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team. We appreciate your interest and wish you the best! Why Apply Through Jobgether? Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time. #LI-CL1 This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Senior Billing Compliance Analyst based in United States. This is a senior-level opportunity supporting a healthcare billing compliance program in a remote environment.You will serve as a subject matter expert across hospital and professional billing, coding, charging, and regulatory compliance.The role combines complex auditing, data analysis, investigations, and proactive risk prevention.You will work closely with compliance leaders, revenue cycle teams, coding professionals, clinical departments, and operational stakeholders.Your insights will help identify systemic risks, strengthen billing practices, and improve compliance across the organization.The position offers significant autonomy, exposure to senior leadership, and the opportunity to influence policies, training, and process improvements.Recent hands-on experience with Epic HB or PB Billing Compliance is essential for success in this role.