Compliance Officer - HIPAA, Prior Authorization & Billing

Orange Tree Systems


Date: 2 weeks ago
City: Remote
Contract type: Full time
Remote
We're hiring a Compliance Officer to own the regulatory backbone of our healthcare operations — across HIPAA, prior authorization, and medical billing. This is a high-impact role at the intersection of patient privacy, payer regulations, and revenue integrity. You'll build and enforce the policies that protect patient data, keep our authorization workflows audit-ready, and ensure every billed claim meets federal, state, and payer standards.

If you live for clean audits, hate sloppy documentation, and want to be the person leadership trusts when the regulators come knocking this is your seat.

Requirements

Bachelor's degree in Healthcare Administration, Nursing, Law, Business, or related field
5+ years of compliance experience in a healthcare, payer, or revenue cycle environment
Deep working knowledge of HIPAA Privacy & Security Rules, prior authorization regulations, and U.S. medical billing/coding standards (ICD-10, CPT, HCPCS)
Experience conducting risk assessments, internal audits, and breach investigations
Familiarity with CMS, OIG, OCR, and commercial payer audit processes
Strong written communication you can write a policy a nurse will actually read and an audit response a regulator will accept
Discretion, judgment, and the spine to escalate uncomfortable findings


Preferred Qualifications

Certifications: CHC (Certified in Healthcare Compliance), CHPC (Certified in Healthcare Privacy Compliance), CHPS, CPC, CCS, or CIPP/US
Experience with EHR/EMR systems (Epic, Cerner, athenahealth), claims platforms, and GRC tools
Prior exposure to utilization management or pharmacy benefit management (PBM) compliance
Experience drafting and negotiating Business Associate Agreements
Knowledge of state-specific privacy laws (CCPA, NY SHIELD, Texas Medical Records Privacy Act, etc.)

Timings: 6:00 PM - 3:00 AM
Location: Lake City, Lahore

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