South Shore Health · 5 days ago
Compliance Billing and Coding Manager
Weymouth, MA
Full-time
Onsite
Senior Level
7+ years expSouth Shore Health is a healthcare organization seeking a Compliance Billing and Coding Manager. This leadership role involves overseeing coding and compliance auditors, ensuring compliance with laws and regulations, and managing billing audit activities.
Health CareHome Health CareHospitalNon Profit
Hiring Manager
Julie Simboli
Responsibilities
Monitors organization wide compliance with federal and state billing regulatory guidance
Conducts prospective or retrospective coding and billing compliance audits
Serves as an independent resource to clinical or operational departments on coding, documentation and regulatory guidelines
Develops, prepares and reports compliance metrics to the Compliance Audit and Risk Committee and as needed
Assists the Chief Compliance Officer with the development and implementation of the annual compliance risk assessment and internal work plan
Participates in development training tools and materials
Delivers education to providers, clinical and department staff on compliant documentation and regulatory guidelines
Manages the Compliance audit team within the Compliance office
Identifies trends in billing, coding and documentation errors. Recommends and monitors implementation of corrective action plans
Develops SSH compliance policies and procedures as required
Performs other related duties as assigned
Qualification
Required
Bachelor's or Associate's Degree in Health Information Management or related area of discipline
7+ years of hospital/clinical coding experience
Expertise in ICD-10-CM, ICD-10-PCS, CPT/HCPCS coding
In depth knowledge and experience with Centers of Medicare and Medicaid Services regulatory guidance
Audit methodology
Develop and effectively deliver coding/billing education to physicians and organization colleagues
Work collaboratively with colleagues across all facets of the organization
Excellent interpersonal and communication skills
Knowledge of computer systems and software used in functional area
Actively participate in continued learning & development
Analyze and develop solutions to complex, varied problems
Develop and implement training curriculum for adult learners
Perform research regarding regulatory requirements
Apply judgment and make informed decisions
Superior attention to detail
Excels at creative problem-solving and creating efficiencies
Excellent project management skills; skilled with independently planning, prioritizing and meeting deadlines
Proficiency with Microsoft Office applications
Preferred
Certified Medical Coder through AHIMA (CCS, CCS-P) or AAPC (CPC, CPMA)
EPIC a plus
Company
South Shore Health
South Shore Health System is a not-for-profit charitable health system offering primary & specialty care, hospital care & community care.
5001-10000 employees
Funding
Current Stage
Late StageLeadership Team
Allen L. Smith
President/CEO
Recent News
2025-12-02
2025-11-26
2025-09-12
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