Job Description

A growing healthcare billing company, is seeking a Director of Compliance to lead and oversee their Compliance department and its sub-teams.

This key leadership role focuses on maintaining up-to-date regulatory standards and ensuring that clients remain fully informed and compliant with evolving state and payor requirements. The Director will manage three specialized teams: the State and Payor Review team, responsible for monitoring and interpreting relevant regulations and guidelines; the Auditing team, which handles prepayment reviews, post-payment audits, and medical record requests; and the Coding team, which ensures that all billing codes and modifiers are accurately applied in accordance with specific payor and client needs.

Responsibilities

• Lead Compliance Teams: Oversee and support the State and Payor Guidelines team, Auditing team, and Coding team to ensure operational excellence and regulatory alignment.
• Audit Oversight: Manage prepayment and post-payment audit processes, including conducting mock audits to identify risk areas and improve future audit performance.
• Client Compliance Strategy: Translate complex payor guidelines into clear, actionable insights to support client service delivery in ABA.
• Legal & Client Liaison: Work closely with legal counsel to resolve compliance discrepancies and maintain regular client communication on relevant payor changes and updates.

Skills

• Leadership & Team Management: Proven ability to lead, manage, and hold accountable multiple teams or sub-teams effectively.
• Analytical Thinking: Strong ability to analyze compliance data and regulatory documents to make strategic decisions.
• Communication: Excellent written and verbal communication skills; adept at simplifying complex regulatory information for clients.
• Client-Focused: Strong orientation toward client success, with the ability to understand and support their service needs.

Requirements

• 5+ years of experience in compliance, auditing, or regulatory affairs (healthcare or ABA experience strongly preferred).
• In-depth knowledge of state and payor guidelines, particularly related to ABA services.
• Experience working with or leading legal and compliance teams in a client-facing capacity.

Location: Monroe, NY | Hours Full-time. | Salary: $100-150k | Job#960 |