Hoag Health System · 1 day ago
Program Manager Revenue Integrity Compliance: Corporate Compliance
1190 Baker St, Costa Mesa, CA, 92626, US
Full-time
Onsite
Mid Level
$49.63/hr - $81.93/hr
4+ years expHoag Health System is a nonprofit regional health care delivery network in Orange County, California. The Program Manager Revenue Integrity Compliance is responsible for supporting the implementation of the Revenue Integrity Compliance Program and ensuring compliance in billing, coding, and revenue cycle operations.
Hospital & Health Care
Responsibilities
The Program Manager Revenue Integrity Compliance supports implementation of the Revenue Integrity Compliance Program for Hoag Memorial Hospital Presbyterian and its affiliated companies (collectively “Hoag”)
The Program Manager Revenue Integrity Compliance is a key corporate compliance role providing onsite support of billing, coding and revenue cycle compliance related matters for Hoag enterprise-wide
Possesses working knowledge of revenue cycle operations, regulatory and compliance rules and regulations, various payer reimbursement practices and government billing audits
In collaboration with the Sr. Principal, Revenue Integrity Compliance, the implements processes to prevent fraud, waste, and abuse
Researches and interprets billing and coding guidelines and CMS reimbursement regulations applicable to Hoag service lines
Develops presentations, education and provide training on new standards and conduct audits to ensure compliance
Under limited supervision, supports the operations of the Revenue Integrity Compliance Program which includes special projects, assessment and analysis, performing audits, conducting investigations, responding to compliance questions and working with the revenue cycle departments
Performs other duties as assigned
Qualification
Required
A minimum of four (4) years of relevant compliance and/or revenue cycle experience in an acute care setting or multi-specialty medical group
Working knowledge of government and commercial billing and coding regulations and guidance
Familiarity with Local Coverage Determinations (LCDs), National Coverage Determinations (NCDs) and other CMS billing and coding guidelines for Hoag services
Certified in Healthcare Compliance (CHC) or other compliance or coding certification subject to approval by the Sr. Principal Revenue Integrity Compliance or must obtain certification within 6 months of hire
Preferred
Epic experience preferred
Certified Coder Professional (e.g., CPC, COC, CPMA), or Certified Coding Specialist (CCS)
Company
Hoag Health System
Hoag is a nonprofit, regional health care delivery system in Orange County, California.
5001-10000 employees
Funding
Current Stage
Late StageLeadership Team
Robert Braithwaite
President and Chief Executive Officer
Eric Cheung
Chief Legal Officer, General Counsel, Senior Vice President
Recent News
PR Newswire
2025-07-14
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