Network Manager, Billing Compliance

WMCHealth

Valhalla, NYFull-time$120–168K/yrSeen 3w agoSeen in employer's feed 1 day ago

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At a glance

Compensation

$120–168K/yr

Location

Valhalla, NY

Schedule

Full-time

Work Authorization

Not specified

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Requirements

Credentials this posting asks for.

Certified Professional CoderBachelor's degree

Job overview

The Network Manager, Billing Compliance leads billing compliance operations across the health system, ensuring professional and ancillary billing practices comply with regulations, payer requirements, and organizational policies. The role oversees audits, monitoring, education, corrective action plans, and collaboration to reduce compliance risk and support accurate reimbursement. It also leads a team and works with providers and staff on documentation and coding accuracy.

Skills & qualifications

RequiredNice to have

Skills

Change LeadershipInfluencingCommunicationPresentation SkillsCompliance AuditingCompliance GuidelinesCompliance RegulationsEPICMD AuditNavexCernerWorkdayTeams

Qualifications

5 Years Billing Compliance Experience3 Years Leadership ExperienceBachelor's Degree in Related FieldCertified Professional CoderLarge Academic Medical Center Experience

Full job description

Network Manager, Billing Compliance

Company: NorthEast Provider Solutions Inc.

City/State: Valhalla, NY

Category: Executive/Management

Department: Compliance- WMC Health

Union: Yes

Union Name: N/A

Position: Full Time

Hours: M-F, 9am-5pm

Shift: Day

Req #: 49827

Posted Date: Sep 16, 2026

Hiring Range: $120,220-$168,155

Apply Now

External Applicant link (https://pm.healthcaresource.com/cs/wmc1/#/preApply/34125) Internal Applicant link

Job Details:

Job Summary:

The Network Manager, Billing Compliance, is responsible for leading and managing billing compliance operations across the health system. This role ensures that professional and ancillary billing practices comply with federal and state regulations, payer requirements, organizational policies, and industry standards. The Network Manager develops and oversees compliance programs, auditing and monitoring activities, education initiatives, corrective action plans, and cross-functional collaboration efforts designed to reduce compliance risk and support accurate reimbursement. Specific duties include managing and overseeing prospective and retrospective audits/external reviews of documentation and coding and working with providers and staff to ensure the accuracy and completeness of the medical record. Oversee training, education and coaching of providers and staff regarding documentation and coding in compliance with Centers for Medicare and Medicaid (CMS) documentation and coding regulations.

Responsibilities:

Manage system-wide billing compliance programs and monitoring activities while ensuring adherence to CMS and state regulatory requirements.
Direct routine and targeted billing audits for professional, hospital, and ancillary services
Analyze and quality assess audit findings to identify trends, risks, and opportunities as well as to provide feedback to staff and internal leaders.
Oversee corrective action plans and monitor effectiveness of remediation efforts.
Monitor regulatory and payer policy changes that may impact billing and reimbursement practices.
Support external audits, government inquiries, and payer investigations while collaborating with leaders across various departments to ensure timely and compliant response.
Develop and deliver billing compliance training programs for revenue cycle staff, providers, managers, and operational leaders.
Lead and mentor a team of compliance analysts, auditors, and specialists.
Promote and establish departmental goals while improving staff key performance indicators.

Qualifications/Requirements:

Experience:

5 years of experience in billing compliance, required
3 years of leadership or management experience with a team of at least three to five people, required
Experience within a large academic medical center, preferred.

Education: