Billing Compliance Educator

Reporting to the Manager of Billing Compliance, the Billing Compliance Curriculum Development Specialist designs, implements, and maintains a comprehensive billing compliance education and awareness program that supports adherence to federal and state regulations and aligns with industry standards.

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.

Requirements

• 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.
• 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.

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.

Qualifications

• One or more of the following certifications required: CPC, CCS, CCS-P, CPMA, COC, RHIT, RHIA.

Pay

$93,800.00 - $106,000.00