Analyst, Compliance

About the Role The Analyst, Compliance at CUIMC CFO supports oversight and advancement of professional fee compliance, billing integrity, and regulatory adherence programs. As a subject matter expert in coding, billing, and reimbursement, you will ensure compliance with CMS, federal and state laws, and coding guidelines, providing guidance for audits, documentation reviews, education, risk assessments, and corrective actions. What You'll Do

• Provide ongoing risk-based coding audits for complex services across specialties, focusing on Medicare/Medicaid, medical necessity, and NCD/LCD requirements; include retrospective audits for established providers and prospective audits for newly onboarded providers to ensure documentation, coding accuracy, and billing compliance.
• Manage departmental compliance teams under Sr. Director and Chief Compliance Officer; collaborate with central revenue office and departmental teams to address revenue and billing integrity needs.
• Provide advisory guidance on CPT/HCPCS and ICD-10 guidelines; educate on facility guidance, professional fee billing (global surgical packages, modifier usage, incident-to services, split/shared services) and emerging regulatory changes.
• Assist with CUIMC’s annual compliance work plan and education curriculum including monthly Compliance Forums; help develop and deliver educational sessions on coding, documentation, payer-specific billing requirements.
• Collaborate with clinical staff, providers, and admins to address compliance issues; assist with development and management of policies and procedures.
• Support Compliance Leadership with other assignments and related responsibilities as needed. What We're Looking For
• Bachelor's degree or minimum four years direct experience in healthcare professional fee billing, coding, and/or compliance, preferably in an academic medical center or large healthcare system.
• Current CPC/CCS-P or related coding credential required; expert knowledge of E/M guidelines and surgical coding in multiple specialties; preference in orthopedics, surgery, and cardiology; high working knowledge in more.
• Epic EHR experience; experience using audit tools (e.g., Audit Manager, MDAudit).
• Excellent analytical and communication skills (oral and written); proficiency in Microsoft Office; strong project management and time management; self-starter, autonomous and self-disciplined.
• Preferred: CPMA certification; Bachelor's degree in Health Information Management, Health Administration, Business, Finance, or related field, or equivalent combination of education and experience. Nice to Have
• CPMA certification. Compensation & Benefits
• Salary Range: $80,000 - $90,000
• Hybrid schedule (onsite and remote)