Compliance Manager

Brault

. Oversee adherence to the Company’s compliance program using OIG Compliance Program Guidance for Third-Party Medical Billing Companies as a guide .

Posted 11/10/2026full-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 ICD10-CM and CPT coding principles, federal regulations, and compliance program management in healthcare. Proven ability to lead compliance training, conduct audits, and implement effective compliance strategies to mitigate risks.

Highest-signal resume keywords

ICD10-CM CodingCPT CodingFederal Regulations ComplianceAuditing ExperienceCompliance Training

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Coding PrinciplesBilling GuidelinesCompliance Program ManagementInternal AuditsRisk MitigationPayer Appeals ManagementPrepayment Review ResolutionCPT Code UpdatesReimbursement AuditsFraud Investigation

Soft Skills

Organizational SkillsAnalytical SkillsWritten CommunicationOral CommunicationJudgment

Industry Keywords

Healthcare ComplianceMedical BillingCompliance EducationFraud PreventionProvider ScreeningCompliance CommitteeSanction ReportPatient ComplaintsRegulatory ChangesStandards of Conduct

About the role

Key responsibilities & impact

Oversee adherence to the Company’s compliance program using OIG Compliance Program Guidance for Third-Party Medical Billing Companies as a guide
Assist the General Counsel in implementing a compliance committee and lead and conduct all 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 arrange training on relevant changes
Revise the compliance program based on company needs and changes in laws, policies, and procedures
Review employee certifications and ensure understanding of standards of conduct
Develop, coordinate, and participate in compliance education and training programs
Coordinate personnel and provider screening against the Cumulative Sanction Report
Coordinate 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 compliance or provider service problems
Research and develop solutions for coding and billing situations
Establish and perform internal reimbursement-coding audits and report findings bi-monthly
Track error rates and ensure improvement or recommend further steps
Provide pertinent new and deleted CPT codes for client fee schedule updates
Troubleshoot coding issues with business associates and internal personnel
Communicate with payers regarding prepayment review resolution
Review accounts and coordinate resolution of 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
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
Ability to exercise judgment and propose courses of action where precedent may not exist
Experience in medical billing and compliance in healthcare preferred
Manages payer appeals specialist