Compliance Officer - Medical Billing & RCM

Remote Full-time
We are seeking an experienced Medical Billing Compliance Officer to oversee and strengthen compliance practices for a behavioral healthcare billing company that provides third-party billing and RCM services through an EMR platform. The ideal candidate will have direct experience ensuring compliance for medical billing companies handling behavioral health clients, including ABA and mental health providers. This role involves reviewing claim workflows, verifying adherence to payer and regulatory requirements, and ensuring the company’s billing operations meet federal, state, and contractual compliance standards.Responsibilities- Oversee compliance practices for third-party billing operations supporting multiple behavioral health clients- Review claim submissions, documentation, and denial patterns for payer and regulatory compliance- Develop and maintain written compliance policies, audit checklists, and training programs for billing staff- Perform periodic internal and external audits to identify potential risks or improper billing activity- Provide corrective action plans and guide management on remediation steps- Ensure compliance with HIPAA, OIG, CMS, and payer-specific requirements- Monitor regulatory changes and update company policies and procedures accordinglyQualifications- Minimum five years of experience in medical billing compliance, ideally for a third-party billing or RCM company- Strong knowledge of HIPAA, CMS, OIG, and payer compliance standards- Experience with ABA or mental health billing strongly preferred- Compliance certification such as CHC, CPCO, or equivalent preferred- Excellent written communication, documentation, and training skills- Familiarity with EMR, clearinghouses, and payer portals Apply tot his job
Apply Now →

Similar Jobs

Compliance Officer (Paralegal – Medical Aesthetics)

Remote Full-time

RN Clinical Regulatory Compliance Specialist

Remote Full-time

Healthcare Regulatory Compliance Specialist: Vendor Management and Audit

Remote Full-time

Compliance Analyst - Performance and Oversight

Remote Full-time

RN Clinical Regulatory Compliance Specialist

Remote Full-time

[Hiring] Operational Compliance Specialist @Care Access

Remote Full-time

Compliance Officer - Remote local to CA preferred

Remote Full-time

Clinical Compliance Professional, CenterWell

Remote Full-time

Regulatory Compliance Officer - CCC | Clinical Trials Office

Remote Full-time

Regulatory Compliance Officer – Clinical Trials

Remote Full-time

Customer Experience Consultant, ShowingTime

Remote Full-time

WorkHero: Remote Senior HVAC Office Manager

Remote Full-time

[Hiring] Director of Requirements & Capabilities, Eastern Region - Space Systems @SEAKR Engineering

Remote Full-time

Head of Ecommerce Operations

Remote Full-time

IAM Senior Consultant – Remote/Delivery Center role in Alexandria, VA

Remote Full-time

RPA Architect- Senior Consultant

Remote Full-time

business systems analyst senior, Specialty Services (Remote, U.S.)

Remote Full-time

Part-Time Data Entry Specialist for Teens – Flexible Hours, Skill Development, and Work-from-Home Options at blithequark

Remote Full-time

Technical Project Manager for ERP Implementation | Prominence Advisors | Remote (United States)

Remote Full-time

Prior Authorization Specialist

Remote Full-time
← Back to Home