Responsible for performing healthcare compliance audits, monitoring activities, and investigations across claims, billing, coding, documentation, reimbursement, denials, payment adjustments, recoupments, refunds, and patient financial responsibility.
The role supports compliance program operations, including policy and procedure maintenance, training support, regulatory monitoring, recordkeeping, reporting, and coordination with internal stakeholders to address findings and strengthen compliance controls.
Bachelor’s degree in healthcare administration, business, compliance, finance, accounting, health information management, or a related field; equivalent relevant experience may be considered.
At least 3 years of experience in healthcare compliance, auditing, billing, coding, revenue cycle, reimbursement, healthcare operations, or a related field.
Working knowledge of healthcare compliance concepts, billing and reimbursement processes, documentation requirements, and regulated healthcare operations.
Ability to independently conduct reviews or audits, analyze findings, identify trends and root causes, and communicate practical recommendations.
Strong written communication, organization, documentation, analytical, and follow-through skills.
Preferred experience includes DME/HME, DMEPOS, medical device, or other highly regulated healthcare environments; claims and documentation auditing; overpayment identification; corrective-action monitoring; payor audits; healthcare investigations; and certifications such as CHC, CPC, CPMA, RHIA, or CIA.
Location
Denver, Colorado, US
Employment Type
Full-time
Experience Level
Intermediate Level
Salary Range
$85,000 - $85,000
Remote work allowed
No
Posted
1 month ago