Boston Neurobehavioral Associates
US Behavioral Health Care Experienced Certified Professional Compliance Officer CPCO (AAPC)
Karachi, Sindh, Pakistan - Full Time
Citadel Healthcare Management (PVT) LTD. provides healthcare management services for practices across North America. Our dedicated team supports a wide range of medical administration tasks, working collaboratively across multiple disciplines.
Our mission is to offer employees meaningful opportunities to apply their expertise, grow in their careers, and contribute to the organization’s ongoing success.
We are committed to creating a workplace where employees feel valued, supported, and motivated. By fostering a collaborative and engaging environment, we ensure that every contribution is recognized and appreciated.
At Citadel, diversity and inclusion are at the heart of our culture. We welcome individuals from all backgrounds—regardless of gender, ethnicity, age, religion, lifestyle, or disability—and embrace the unique perspectives and experiences they bring. Through teamwork, innovation, and continuous professional development, we empower our employees to thrive and drive progress within the organization.
Our mission is to offer employees meaningful opportunities to apply their expertise, grow in their careers, and contribute to the organization’s ongoing success.
We are committed to creating a workplace where employees feel valued, supported, and motivated. By fostering a collaborative and engaging environment, we ensure that every contribution is recognized and appreciated.
At Citadel, diversity and inclusion are at the heart of our culture. We welcome individuals from all backgrounds—regardless of gender, ethnicity, age, religion, lifestyle, or disability—and embrace the unique perspectives and experiences they bring. Through teamwork, innovation, and continuous professional development, we empower our employees to thrive and drive progress within the organization.
The Certified Professional Compliance Officer (CPCO) will lead the compliance function within the medical billing company, ensuring all billing, coding, and reimbursement practices adhere to federal, state, and payer regulations. This role is critical in safeguarding the organization against fraud, denials, and regulatory penalties while promoting ethical standards and operational efficiency.
Key Responsibilities
- Regulatory Compliance Oversight
- Ensure billing and coding practices comply with CMS, OIG, HIPAA, and payer-specific guidelines.
- Monitor compliance with CPT, ICD-10, HCPCS, and other coding standards.
- Oversee denial management processes and ensure corrective actions are implemented.
- Audit & Risk Management
- Conduct internal audits of claims, coding accuracy, and documentation.
- Identify compliance risks and develop mitigation strategies.
- Prepare for external audits and act as the primary liaison with regulators and payers.
- Policy & Procedure Development
- Draft, update, and enforce compliance policies tailored to billing operations.
- Establish protocols for handling denials, rejections, and appeals.
- Training & Education
- Provide ongoing compliance training to billing staff, coders, and management.
- Educate teams on regulatory updates, payer requirements, and fraud prevention.
- Reporting & Communication
- Generate compliance reports for leadership and stakeholders.
- Communicate audit findings and recommend corrective measures.
- Collaborate with HR, IT, and operations to integrate compliance into workflows.
- CPCO certification (AAPC) required.
- Bachelor’s degree in healthcare administration, business, or related field.
- 3–5 years of experience in medical billing compliance, auditing, or healthcare regulatory oversight.
- Strong knowledge of CPT, ICD-10, HCPCS, HIPAA, CMS, and payer-specific regulations.
- Experience with denial management and appeals processes.
- Excellent communication, analytical, and leadership skills.
- Ethical decision-making and integrity.The Certified Professional Compliance Officer (CPCO) will lead the compliance function within the medical billing company, ensuring all billing, coding, and reimbursement practices adhere to federal, state, and payer regulations. This role is critical in safeguarding the organization against fraud, denials, and regulatory penalties while promoting ethical standards and operational efficiency.
Key Responsibilities - Regulatory Compliance Oversight
- Ensure billing and coding practices comply with CMS, OIG, HIPAA, and payer-specific guidelines.
- Monitor compliance with CPT, ICD-10, HCPCS, and other coding standards.
- Oversee denial management processes and ensure corrective actions are implemented.
- Audit & Risk Management
- Conduct internal audits of claims, coding accuracy, and documentation.
- Identify compliance risks and develop mitigation strategies.
- Prepare for external audits and act as the primary liaison with regulators and payers.
- Policy & Procedure Development
- Draft, update, and enforce compliance policies tailored to billing operations.
- Establish protocols for handling denials, rejections, and appeals.
- Training & Education
- Provide ongoing compliance training to billing staff, coders, and management.
- Educate teams on regulatory updates, payer requirements, and fraud prevention.
- Reporting & Communication
- Generate compliance reports for leadership and stakeholders.
- Communicate audit findings and recommend corrective measures.
- Collaborate with HR, IT, and operations to integrate compliance into workflows.
- Qualifications
- CPCO certification (AAPC) required.
- Experience in outpatient psychiatric or behavioral health practices USA.
- Bachelor’s degree in healthcare administration, business, or related field.
- 3–5 years of experience in medical billing compliance, auditing, or healthcare regulatory oversight.
- Strong knowledge of CPT, ICD-10, HCPCS, HIPAA, CMS, and payer-specific regulations.
- Experience with denial management and appeals processes.
- Excellent communication, analytical, and leadership skills.
- Competencies
- Ethical decision-making and integrity.
What We Offer
- Competitive salary package
- Professional growth opportunities
- Collaborative and supportive work environment
- Exposure to U.S. healthcare systems and compliance standards
