The role oversees day-to-day non-clinical healthcare operations, ensuring absolute compliance with federal and state regulations while streamlining administrative workflows. This position serves as the operational backbone, bridging the gap between clinical providers, billing systems, and regulatory entities.
The successful candidate will manage critical processes including provider credentialing, billing cycle audits, HIPAA compliance monitoring, and Electronic Health Record (EHR) optimization. This is a remote role requiring high autonomy, strong analytical capabilities, and deep familiarity with the US healthcare system.
Key Responsibilities
- Manage and audit daily non-clinical healthcare operations to ensure strict adherence to HIPAA, CMS guidelines, and state-specific regulations
- Oversee the provider credentialing and enrollment processes across commercial insurance networks and government payers
- Monitor medical billing workflows, claims submissions, and revenue cycle management metrics to identify and resolve operational bottlenecks
- Maintain, configure, and optimize Electronic Health Record (EHR) and Practice Management systems for data accuracy and security
- Analyze operational performance data to generate monthly compliance reports and key performance indicator (KPI) dashboards for leadership
- Develop and update standard operating procedures (SOPs) for administrative staff and coordinate annual compliance training programs
- 3–6 years of experience in healthcare administration, medical practice management, or healthcare operations in the US
- Thorough understanding of HIPAA regulations, CMS standards, and medical coding systems (ICD-10, CPT)
- Proficiency with major EHR platforms (such as Athenahealth, Epic, or eClinicalWorks) and administrative database tools
- Strong analytical skills with experience using Excel or BI tools to track and report operational metrics
- Bachelor's degree in Healthcare Administration, Business Administration, or a related field
- Bonus: Certified Healthcare Administrative Professional (CHAP), Certified Medical Practice Executive (CMPE), or previous remote experience in a digital health company
About the company
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