Billing And Compliance Audit Specialist

Summary

Join BillionToOne, a leading molecular diagnostics company, as a Billing and Compliance Audit Specialist. You will conduct internal and external billing and compliance audits, ensuring adherence to company policies and regulatory standards. Responsibilities include analyzing audit findings, collaborating with payors, developing training materials and SOPs for the reimbursement team, and reporting to the VP of Reimbursement. This role requires proven experience in billing and compliance audits within healthcare, strong communication skills, and proficiency in data analysis. Preferred qualifications include a Bachelor's degree in a related field and relevant certifications. BillionToOne offers a comprehensive benefits package, including competitive compensation, generous parental leave, retirement savings program, and various perks.

Requirements

• Proven experience in billing and compliance audits, preferably within the healthcare industry
• Strong understanding of reimbursement processes and regulatory requirements
• Excellent communication and interpersonal skills for effective collaboration with internal teams and external partners
• Ability to develop training materials and conduct engaging training sessions
• Proficient in data analysis and presenting complex information clearly and concisely
• Detail-oriented with strong analytical skills
• Ability to work independently and as part of a team
• Strong organizational and time management skills
• Proficient in using audit and compliance software tools
• Comfortable working with cross-functional teams and managing multiple priorities

Responsibilities

• Perform regular and thorough internal billing and compliance audits to ensure adherence to company policies and regulatory standards
• Analyze and interpret audit findings, identify areas of risk, and recommend corrective actions
• Collaborate with payors and third parties to manage the full external audit lifecycle, including tracking, response, and communication
• Work closely with internal and external legal counsel to ensure all audit-related activities comply with legal and regulatory requirements
• Conduct comprehensive training for the reimbursement team to enhance understanding of billing and compliance standards
• Develop innovative training materials, including written SOPs, video training, and other creative methods to effectively engage and educate team members
• Implement ongoing retraining initiatives to ensure continuous improvement and adherence to best practices
• Create and maintain up-to-date SOPs for the reimbursement function, ensuring clarity and accessibility for all team members
• Regularly review and update SOPs to reflect changes in regulations or company policies
• Report audit findings and compliance metrics directly to the VP of Reimbursement
• Present detailed audit reports and insights to key leaders within the organization, highlighting significant trends and recommendations for improvement

Preferred Qualifications

• Bachelor’s degree in Finance, Business Administration, Healthcare Management, or a related field
• Certified Professional Coder, Certified Professional Biller and/or Certification in Healthcare Compliance

Benefits

• Multiple medical benefit options; employee premiums paid 100% of select plans, dependents covered at 80%
• Extremely generous Family Bonding Leave for new parents (16 weeks, paid at 100%)
• Retirement savings program including a 4% Company match
• Free daily on-site lunches provided from top eateries
• Latest and greatest hardware (laptop, lab equipment, facilities)
• A variety of perks on campus (state of the art gym, restaurant)
• Free on-site EV charging (compatible with all EVs, including Tesla)
• Working with a team of ‘rockstars’ who bring out the best in everyone
• Open, transparent culture that includes weekly Town Hall meetings
• The ability to indirectly or directly change the lives of hundreds of thousand patients
• At BillionToOne, we are proud to offer a combination of a (1) base pay range (actual amount offered is based on experience and salary/equity options split that the candidate chooses), (2) generous equity options offering, (3) corporate bonus program, on top of (4) industry leading company benefits (free healthcare options, 401k match, very generous fully paid parental leave, etc.)
• For this position, we offer a total compensation package of $135,450 per year, including a base pay range of $81,600 - $102,000 per year