Compliance Manager

Brault

. Assure that the Company, its officers and management, employees, business associates, and clients adhere to applicable government law, regulations, policies, and procedures .

Posted 9/22/2026full-timeRemote • California • United StatesMid-LevelSenior💰 $110,000 - $125,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates extensive knowledge of healthcare compliance, including ICD10-CM and CPT coding principles, federal regulations, and auditing practices. Proven ability to develop and implement compliance training programs while effectively communicating with stakeholders and managing compliance issues.

Highest-signal resume keywords

Healthcare Compliance ExperienceICD10-CM and CPT Coding KnowledgeAuditing ExperienceCompliance CertificationRegulatory Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

ICD10-CM CodingCPT CodingHealthcare ComplianceAuditingRevenue Cycle ManagementRegulatory ComplianceInternal InvestigationsCoding TroubleshootingMedicare AuditsCompliance Program Development

Soft Skills

Organizational SkillsWritten CommunicationOral CommunicationAnalytical SkillsJudgment

Tools & Technologies

Standard Office Equipment

Certifications & Qualifications

Compliance Certification

Industry Keywords

Healthcare OperationsPhysician Practice ManagementHealthcare ConsultingRegulatory ExperienceMulti-State OperationsFraud PreventionPatient Complaints ManagementCumulative Sanction Report

About the role

Key responsibilities & impact

Assure that the Company, its officers and management, employees, business associates, and clients adhere to applicable government law, regulations, policies, and procedures
Oversee adherence to the Company’s compliance program using OIG Compliance Program Guidance as a guide
Assist the General Counsel in implementing a compliance committee and lead and conduct meetings
Establish methods to improve efficiency and service quality and reduce vulnerability to fraud, abuse, waste, and other risks
Investigate, review, and respond to compliance issues, concerns, and complaints
Review governmental health plan publications and circulate or arrange training about relevant changes
Periodically revise the compliance program based on changes in company needs, laws, and payer policies
Review employee certifications and ensure standards of conduct are received, read, and understood
Develop, coordinate, and participate in compliance education and training programs
Coordinate personnel and provider checks against the Cumulative Sanction Report
Assist operations managers with internal compliance reviews and monitor departmental activities
Design and coordinate internal investigations and corrective actions
Develop policies encouraging reporting of suspected fraud and improprieties without retaliation
Process Medicare pre- and post-payment audits
Process patient complaints and disputes involving possible compliance or provider service problems
Research and develop answers to difficult coding or billing situations
Establish and perform internal reimbursement-coding audits
Report internal audit findings to Leadership bi-monthly
Track error rates and ensure improvement or outline further steps
Provide pertinent new and deleted CPT code lists for client fee schedule updates
Assist business associates and internal personnel with coding troubleshooting
Communicate with payers regarding prepayment review resolution
Review accounts and coordinate personnel needed to resolve prepayment reviews
Provide quarterly compliance training
Assist with training and troubleshooting for payment deficiencies

Requirements

What you’ll need

Excellent organizational skills
Excellent written and oral communication skills
Excellent analytical skills
Undergraduate degree in related field preferred
Compliance certification preferred
5+ years of healthcare compliance, revenue cycle, auditing, or regulatory experience
Experience supporting multi-state healthcare operations
3+ years of experience within healthcare revenue cycle operations, physician practice management, healthcare consulting, or healthcare services
Experience with large physician groups, hospital systems, or RCM organizations, preferred
Extensive knowledge of ICD10-CM and CPT coding principles and guidelines
Extensive knowledge of federal regulations and policies pertaining to physician documentation, coding, and billing
4+ years coding experience
3+ years auditing experience
1-2 years supervisory experience
3+ years’ experience responding to informal and government complaints
Ability to exercise judgment and propose courses of action where precedent may not exist
Experience in medical billing and compliance in healthcare preferred
Role operates in a professional office environment
Ability to use standard office equipment such as laptop computers, copiers and line/cell phones
Ability to occasionally lift or move up to 20 pounds