Home/Job Search/Sr. Hospital Compliance Specialist

Sr. Hospital Compliance Specialist

Job ID: 1136731_RR00097571

Facility: NYU Langone Health

Position Type: Full-Time/Regular

Shift: 9am-5pm

Department: Finance/Accounting/Billing, NYU Langone Health

Two female research staff members work together in a laboratory setting.

NYU Langone Health is a world-class, patient-centered, integrated academic medical center, known for its excellence in clinical care, research, and education. It comprises more than 200 locations throughout the New York area, including five inpatient locations, a children’s hospital, three emergency rooms and a level 1 trauma center. Also part of NYU Langone Health is the Laura and Isaac Perlmutter Cancer Center, a National Cancer Institute designated comprehensive cancer center, and NYU Grossman School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. At NYU Langone Health, equity, diversity, and inclusion are fundamental values. We strive to be a place where our exceptionally talented faculty, staff, and students of all identities can thrive. We embrace diversity, inclusion, and individual skills, ideas, and knowledge. For more information, go to nyulangone.org, and interact with us on LinkedInGlassdoorIndeed, FacebookTwitterYouTube and Instagram.

Position Summary:
We have an exciting opportunity to join our team as a Senior Compliance Specialist (Hospital). 

In this role, the successful Senior Compliance Specialist will support the Manager of Hospital Billing Compliance and the Director of Billing Compliance in the development and implementation of the Hospital Billing Compliance program at NYU Langone Health System, to ensure adherence with federal and state billing regulations. Primary responsibilities include conducting audits to determine organizational integrity of billing facility and technical hospital fees including identifying areas requiring improvement and providing recommendations and education to providers and staff.

Job Responsibilities:

    1. Assists with management of the comprehensive Hospital Billing Compliance workplan to ensure that billing and coding of hospital services are in accordance with federal state local and managed care payor regulations
    2. Conducts risk assessments to define audit priorities by evaluating previous audit findings management priorities ICD APC and DRG utilization patterns national normative data CMS and PEPPER initiatives OIG work plans and advisories and healthcare industry best practices
    3. Conducts Hospital Compliance audits consisting of evaluation of adequacy and accuracy of documentation in support of services billed including ICD/CPT/HCPCS and other third party payor codes DRG assignment APC code assignment medical necessity of services and compliance with other documentation coding and billing standards
    4. Adheres to audit timeline and audit protocol standards; assists with development of audit schedules
    5. Prepares written reports of audit findings and recommendations and presents the findings to leadership of the respective department coding staff Health Information Management staff and others as appropriate; evaluates the adequacy of management action plan as needed to improve deficiencies
    6. Evaluates the adequacy and effectiveness of internal and operational controls designed to ensure that processes and practices lead to appropriate execution of regulatory requirements and guidelines related to facility and technical fee documentation coding and billing including federal and state regulations and guidelines CMS and other third party payor billing rules and OIG/OMIG compliance standards
    7. Develops a comprehensive education program to train department managers staff and physicians in all areas of compliance and billing requirements Provides information which is clear and coherent Prepares presentations and develops training materials as needed
    8. Assists Compliance Department management with federal state and other special investigations and audits
    9. Effectively maintains collaborative working relationships with department leadership and Revenue Cycle Operations management team to provide education on improvements in billing and documentation practices
    10. Serves as subject matter expert and authoritative resource on interpretation and application of documentation and coding rules and regulations and medical necessity of services delivered
    11. Annually identifies specific needs for self development and implements a plan to achieve professional growth
    12. Maintains privacy of patient information and confidentiality of compliance information and activities
    13. Assists in any special projects and/or internal or external federal or state agency inquiries and performs and participates in other related duties as required

Minimum Qualifications:

  • Bachelors degree in Finance Healthcare administration or related field
  • Minimum of 4 years of hospital coding and billing experience
  • Certification in clinical coding is required
  • Strong problem solving and analytical skills
  • Excellent verbal and written communication skills
  • Proficiency in Microsoft office
  • Must be able to communicate with physicians senior administrators and office staff
  • Epic systems and/or EHR experience

Preferred Qualifications:
Bachelors degree in Nursing or Masters degree in Nursing Hospital Billing experience in a large academic health care setting 4 5 years of experience in facility fee auditing/coding or medical necessity reviews or related work Ability to understand and interpret medical records hospital bills and the charge master as well as an understanding of all ancillary department functions Holds one of the following coding certifications: MPG Certified Inpatient Coder CIC AHIMA Certified Coding Specialist CCS or AHIMA Certified Coding Associate CCA Proficiency in payment review systems hospital information systems and clinical record information systems Knowledge of regulatory agencies requirements CMS NYS Medicaid OIG and OMIG Strong quantitative analytical communication and interpersonal skills and ability to work collaboratively with team members and others

Qualified candidates must be able to effectively communicate with all levels of the organization.

NYU Langone Health provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you’ll feel good about devoting your time and your talents.

NYU Langone Health is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military and veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision. We require applications to be completed online.
If you wish to view NYU Langone Health’s EEO policies, please click here. Please click here to view the Federal “EEO is the law” poster or visit https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm for more information.

NYU Langone Health provides a salary range to comply with the New York state Law on Salary Transparency in Job Advertisements. The salary range for the role is $81,325.15 – $128,272.72 Annually. Actual salaries depend on a variety of factors, including experience, specialty, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.

To view the Pay Transparency Notice, please click here

Salaries shown on independent jobs related websites reflect market averages and do not represent information obtained directly from NYU Langone. We invite and encourage each candidate to discuss salary/hourly specifics during the application and hiring process.

Related Job Listings

Other Jobs That May Interest You

About NYU Langone Health

Be Where Everyone Is Dedicated to Exceptional Care

NYU Langone is a world-class, patient-centered, integrated academic medical center with Magnet®-recognized status by the American Nurses Credentialing Center (ANCC). Our trifold mission to care, teach, and discover is achieved daily through NYU Langone’s diverse and inclusive culture devoted to excellence across the organization. Here, you can advance your career supported by exceptionally talented faculty and staff in an environment where everyone works together to deliver the best possible outcomes for our patients.

Five staff members of different ethnicities and genders stand together, smiling in an office.

Our Hiring Process

Joining Our Team

Get ready to start your career journey at NYU Langone, where cutting-edge research meets compassionate care, and discover how you can contribute to shaping the future of medicine.

Step 1

Apply Online

The NYU Langone hiring process begins with you applying through our online portal. Be sure to update and upload your resume. Shortly after you submit your application, you will receive an email confirmation. Ten days after applying you will receive a talent assessment to be completed.

Step 2

Schedule Interviews

If selected to continue the interview process, HR will reach out via phone or email first. Then, depending on your position, they will schedule an interview with unit managers or team members. You are encouraged to dress professionally for all interviews.

Step 3

Receive Offer

If you successfully complete the interview process and are identified as a finalist for the position, we will require that you complete a professional reference process. After evaluating the completed references, a decision will be made on who will receive a preliminary offer. If you receive a preliminary offer, HR will start the onboarding process with an agreed-upon tentative start date.

Step 4

Training & Orientation

You will be contacted by an onboarding specialist who will work with you on your pre-boarding requirements. Once fully cleared, we will ask you to complete compliance orientation regulatory training. On your first day, you will attend an online required orientation to acclimate to the health system and report to your new department based on instructions provided by your hiring manager.

Our Awards Reflect a Commitment to Excellence at Every Level

Best Hospitals Honor Roll 2024–2025. U.S. News & World Report
America’s Most Admired Workplaces. Newsweek Plant-A Insights Group 2025
America's Greatest Workplaces 2024. Newsweek Plant-A Insights Group
Magnet Recognized. American Nurses Credentialing Center
Business Group on Health. Best Employers: Excellence in Mental Health 2024
Business Group on Health. Best Employers: Excellence in Health & Well-being 2024
Forbes 2019-2024 America’s Best-In-State Employers Powered by Statista. All Time Champion
Ragan Workplace Wellness Awards Winner
America's Greatest Workplaces for Mental Wellbeing 2024. Newsweek Plant-A Insights Group
MHA Mental Health America. The Bell Seal for Workplace Mental Health. 2024 Platinum
Seramount part of EAB. 100 Best Company 2023
DiversityInc Top Ranked Regional Companies 2023
DiversityInc Top Ranked Hospitals and Health Systems 2023
American Society of Transplantation. AST Living Donor Circle of Excellence

Hear From Our Team

Top Ten Frequently Asked Questions

We offer different employment options to fit every schedule and talent area of interest. These options include full time, part time, per diem, internship, and temporary.
We are growing rapidly and are always looking for exceptional people to join our organization. New positions are posted to our careers site daily.
We update our job postings daily.
All applications should be submitted by clicking the “Apply for This Position” button on any job listing.
To search and apply for our available temporary opportunities, use the Job Search function, which is accessible on the home page and other careers site pages. NYU Langone has various temporary opportunities, including our In-House Temporary Staffing Program. The Program is designed to place highly skilled individuals in temporary assignments throughout NYU Langone to help our departments meet their commitment to quality patient care, research, and operations. These individuals are temporary employees within NYU Langone and adhere to all NYU Langone policies and guidelines.
Paid internship opportunities can be found on our careers site by searching via the Job Search function. Unpaid internships are organized by department. You can explore our departments at NYU Langone to find an internship opportunity that suits your educational endeavors. Additionally, please visit the internship page to learn more about our internship opportunities.

Yes, an email address is required to complete the online application. You must have an active email account, as you will receive email notifications once your application has been received.

In order for your resume to be submitted successfully, it should be in one of the following supported formats: .pdf, .txt, .rtf, .doc, .docx, or .html.

You will receive an email confirmation after you have completed the online application process. To ensure that the information you submitted was completed accurately, you are encouraged to log in to your account and review your information. You will also receive an email confirmation after successfully applying for a specific position. To check the status of your application, please click Check Application Status .

Current employees can check application status on the Steps for Success Career Portal .