Note: The job is a remote job and is open to candidates in USA. Dana-Farber Cancer Institute is a cancer research and patient care organization committed to reducing the burden of cancer through care, education, and research. The Billing Compliance Educator develops and manages billing compliance education programs, creates training materials, delivers provider education, analyzes compliance data, and supports accurate billing and documentation practices. The role also researches regulatory requirements, reinforces audit findings, and assists with reviews, investigations, and special projects.
Responsibilities
- Designs, develops, and maintains a comprehensive billing compliance education program for physicians, advanced practice providers, coders, reviewers, managers, and revenue cycle staff, including onboarding, annual training, and targeted risk-based education
- Develops, updates, and maintains educational materials, including presentations, reference guides, job aids, assessments, and virtual learning modules, to support role-specific compliance training
- Delivers billing compliance education through live, virtual, small-group, and one-on-one formats using effective adult learning principles and instructional methods
- Provides onboarding and ongoing billing compliance training for newly employed physicians, advanced practice providers, and staff, including coverage for educator responsibilities as needed
- Partners with compliance reviewers, department leadership, and revenue cycle operations to reinforce review findings, improve billing and documentation practices, and support corrective action efforts
- Researches coding, billing, documentation, and regulatory issues; responds to questions; and communicates relevant updates and annual changes to physicians, advanced practice providers, coding staff, and billing compliance personnel
- Maintains current knowledge of ICD-10-CM, CPT, HCPCS Level II, and applicable billing, coding, documentation, and specialty-specific regulatory requirements
- Incorporates guidance from CMS, OIG, NCCI, and other applicable regulatory and payer sources into training content, communication tools, and compliance education strategies
- Analyzes review, quality, and compliance data to identify educational gaps, measure training effectiveness, and track participation and outcomes
- Assists with special projects, internal reviews, investigations, reviews, and responses to inquiries from federal, state, or other external agencies
- Maintains the privacy of patient information and the confidentiality of compliance-related information, investigations, and activities
- Identifies annual professional development goals and pursues ongoing learning to maintain subject matter expertise and support continuous improvement
- Performs other related duties as assigned
Skills
- Advanced knowledge of billing compliance regulations and coding guidelines, including ICD-10-CM, CPT, and HCPCS
- Strong instructional design and adult learning skills
- Excellent written and verbal communication skills
- Strong analytical skills with the ability to translate data into actionable education
- Proficiency in Microsoft Office, including Word, Excel, and advanced PowerPoint skills for developing effective presentations and training materials
- Ability to develop, implement, and maintain e-learning modules within a learning management system (LMS)
- Strong organizational skills and ability to manage multiple priorities
- Ability to work independently in a remote environment
- Associate's degree in Health Information Management, Education, or related field required
- Minimum of 5 years of experience in healthcare billing, coding, auditing, compliance, and/or education
- Demonstrated experience in curriculum development, training delivery, and provider education
- One or more of the following certifications required: CPC, CCS, CCS-P, CPMA, COC, RHIT, RHIA
- Experience in oncology professional and technical coding, auditing and billing compliance preferred
- Experience supporting enterprise billing compliance and audit programs preferred
- Experience with Epic preferred
- Experience developing virtual or asynchronous learning content preferred
Company Overview
Company H1B Sponsorship