Pediatric Home Service logo
Pediatric Home Service

Unparalleled care for children with medical complexities.

Compliance Coordinator

ComplianceComplianceFull TimeRemoteLeadTeam 1,001-5,000Since 1990H1B No SponsorCompany SiteLinkedIn

Location

Florida + 6 moreAll locations: Florida | Illinois | Iowa | Kansas | Minnesota | Texas | Wisconsin

Posted

11 days ago

Salary

$30 / hour

Seniority

Lead

Bachelor Degree12 yrs expEnglish

Job Description

Compliance Coordinator

Pediatric Home Service

• Ensure our services meet the highest standards of compliance with government and commercial payer requirements. • Audit medical documentation supporting claims billed to government and commercial payers. • Review documentation for accuracy, completeness, and alignment with payer guidelines. • Analyze payer contracts, fee schedules, databases, and system set-up requirements. • Identify audit trends, variances, deficiencies, and potential compliance risks. • Prepare clear audit reports and communicate findings to appropriate stakeholders. • Conduct follow-up audits to confirm corrective actions have been completed. • Assist with development and maintenance of compliance policies, procedures, audit standards, and reports. • Serve as a resource for billing, reimbursement, documentation, and coding-related questions. • Stay current with Medicare, Medicaid, and commercial payer rules and regulations. • Partner with internal teams to resolve billing and documentation concerns. • Prepare and deliver training related to supported billing and documentation expectations.

Job Requirements

  • Bachelors degree preferred, or equivalent combination of education, training, and related experience.
  • 12 years of experience in healthcare compliance, billing, reimbursement, auditing, documentation review, revenue cycle, DME, home care, or a related healthcare setting preferred.
  • Healthcare compliance or audit experience.
  • DME, home infusion, respiratory, pharmacy, or pediatric healthcare experience.
  • Advanced Excel skills.
  • Experience reviewing documentation for medical necessity and payer compliance.
  • Knowledge of Medicare and Medicaid regulations.
  • Experience preparing audit findings, corrective action summaries, or training materials.
  • Strong understanding of medical documentation, payer requirements, billing support, and compliance standards.
  • Strong analytical skills with the ability to identify patterns, trends, variances, and compliance risks.
  • Excellent attention to detail and ability to manage multiple audits, reports, and follow-up items.
  • Strong written and verbal communication skills, including the ability to present findings clearly to leadership and internal teams.
  • Proficiency with Microsoft Excel; advanced Excel skills strongly preferred.
  • Experience with database maintenance, reporting, or system audits preferred.
  • Knowledge of Medicare, Medicaid, third-party payer reimbursement, coding, and documentation requirements preferred.
  • Ability to work independently, problem-solve, and partner cross-functionally with billing, operations, reimbursement, and compliance teams.

Benefits

  • Holiday Pay
  • Paid Time Off
  • Health and Dental insurance
  • Short & Long-Term Disability and Life Insurance
  • 401K with match & educational benefits

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