Network Manager, Billing Compliance
Role Overview
Lead and manage billing compliance operations across the health system.
Ensure professional and ancillary billing practices comply with regulations, payer requirements, organizational policies, and industry standards.
Oversee compliance programs, audits, education, corrective actions, and cross-functional collaboration.
Key Skills for This Role
Full Job Posting
Job Summary
Lead and manage billing compliance operations across the health system.
Ensure professional and ancillary billing practices comply with regulations, payer requirements, organizational policies, and industry standards.
Oversee compliance programs, audits, education, corrective actions, and cross-functional collaboration.
Position Details
- Position is full time.
- Schedule is Monday through Friday, 9:00 a.m. to 5:00 p.m., day shift.
- The position is associated with the Compliance department and is union-covered.
- Hiring range is $120,220–$152,177 per year.
Responsibilities
- Manage system-wide billing compliance programs and monitoring activities.
- Direct routine and targeted billing audits for professional, hospital, and ancillary services.
- Analyze audit findings to identify trends, risks, and opportunities.
- Oversee corrective action plans and monitor remediation effectiveness.
- Monitor regulatory and payer policy changes affecting billing and reimbursement.
- Support external audits, government inquiries, and payer investigations.
- Develop and deliver billing compliance training programs.
- Lead and mentor compliance analysts, auditors, and specialists.
- Establish departmental goals and improve staff key performance indicators.
Experience and Education
- 5 years of billing compliance experience required.
- 3 years of leadership or management experience with a team of at least three to five people required.
- Experience within a large academic medical center preferred.
- Bachelor’s degree in a related field required.
Licenses and Special Requirements
- Certified Professional Coder certification from the American Academy of Professional Coders required.
- Ability to lead and influence change without conflict.
- Excellent communication and presentation skills.
- Proficiency with compliance audits, guidelines, and regulations.
- Experience with EPIC, MD Audit, Navex, Cerner, Workday, and Teams.
About NorthEast Provider Solutions
NorthEast Provider Solutions Inc. is identified as the employer in the job description.
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