Healthcare Compliance and Audit Specialist - TJ / 1844482

Job description

Our client Cube Healthcare Systems is looking for a Healthcare Compliance and Audit Specialist in Abbottabad. This position does not involve managing a team but requires close coordination with multiple departments to achieve quality assurance and maintain regulatory compliance within all aspects of revenue cycle management including coding, billing, claims processing, payments, accounts receivable, and collections. The executive is responsible for identifying risks through regular audits, supporting the resolution of denials and payer rejections, and preparing comprehensive monthly dashboards in collaboration with operation leads. Candidates must have a minimum of one to two years of experience in billing operations with relevant exposure to compliance audits and medical billing systems. Proficiency in MS Excel, audit tools, and a solid understanding of HIPAA, CMS guidelines, and coding standards such as ICD, CPT, and HCPCS are essential for success in this role. Cube Healthcare Systems offers a competitive salary package with extensive benefits, fostering professional growth and rewarding performance. Job Timing: 5:30pm-2:30am Responsibilities Ensure full compliance of all revenue cycle management processes including coding, billing, claims submission, payment posting, accounts receivable, and collections with applicable healthcare regulations and payer requirements. Conduct regular and thorough audits of claims, medical coding, follow‑up activities, and documentation to detect discrepancies, risks, and potential areas of non‑compliance within healthcare financial operations. Identify compliance‑related denials and payer rejections and work promptly to resolve these issues in collaboration with billing, coding, and operations teams to minimize financial losses and improve claims acceptance rates. Collaborate closely with coding and billing teams to support quality assurance initiatives by providing feedback and training to enhance accuracy and compliance of documentation and processes. Maintain detailed and organized records of compliance audits, findings, corrective actions, and follow‑up activities to ensure ongoing adherence to healthcare laws and internal policies. Prepare accurate and insightful monthly month‑to‑date (MTD) dashboards for all clients, coordinating with operation leads to present compliance status, audit results, and improvement recommendations. Stay updated on changes in healthcare regulations, payer policies, and coding standards such as HIPAA, CMS guidelines, and ICD/CPT/HCPCS coding rules to continually improve compliance monitoring frameworks. Use advanced MS Excel skills and audit tools to analyze data, generate reports, and uncover trends or anomalies that could indicate risks or areas needing corrective action. Provide effective communication and training support within the department to foster awareness and understanding of compliance requirements and promote best practices in revenue cycle management. Adhere strictly to company policies, ethical standards, and confidentiality requirements while managing sensitive healthcare and patient information. Participate actively in team meetings and cross‑departmental collaborations to contribute insights and solutions that drive compliance excellence and operational efficiency. Assist in preparing documentation and evidence required for external audits or inspections performed by regulatory bodies or payers. Support management in developing and refining compliance programs, policies, and procedures to enhance overall organizational governance and risk management. #J-18808-Ljbffr