Billing Compliance Auditor III

• Following established protocols, selecting and reviewing a percentage of records to assess coding documentation, billing, and/or reimbursement practices for compliance with all regulations of federal and state agencies, third-party payers, and hospital policy.
• Maintaining review data and providing feedback to relevant areas in collaboration with appropriate personnel. Assigning performance scores and risk ratings based on audit results.
• Investigating, evaluating, and identifying opportunities for improvement in conjunction with appropriate personnel, recognizing their relative significance in the overall system, and providing guidance to departments regarding internal controls.
• Developing and drafting billing and coding policies for the CHB Foundations in coordination with the Hospital. Developing and maintaining professional skills and knowledge through attendance at relevant conferences, seminars, and other educational programs, participation in professional organizations, and review of current literature.
• Contributing to the teamwork within and between departments and organizations that support hospital operations.
• Providing positive and effective customer service that supports departmental and hospital operations.
• Managing and resolving coding issues in department/foundation Work queues

Schedule: Monday-Friday, 8am-5pm, Remote after training * Training will require onsite presence the first couple of weeks, after which the role will be fully remote*

To qualify, you must have:

• Professional Billing Coding certification (CPC, CCS-P)
• High School Diploma, Associate's or Bachelor's degree preferred,
• 3 years CPT and ICD10 coding experience; including some experience reviewing physician documentation and assisting physicians to meet CPT and ICD10 coding requirements.
• 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.
• Communication skills in order to effectively deal with conflicting views or issues and mediate fair solutions, and well developed writing skills.

Boston Children's Hospital offers competitive compensation and unmatched benefits including flexible schedules, affordable health, vision and dental insurance, child care and student loan subsidies, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition and certain License and Certification Reimbursement, cell phone plan discounts and discounted rates on T-passes.