Healthcare CMS Billing Compliance Manager (Analyst)

Full-time position available with the Fire Department, Billing Division located at 6750 Eastwood Trafficway
Salary Range: $4,619-$6,928/month
Normal Work Days/Hours: Monday-Friday, 8:00 a.m.-5:00 p.m.
Application Deadline Date: September 11, 2025

The professional must be skilled in overseeing claims and audits for Ambulance Billing within the Kansas City Fire Department, focusing on administrative, technical, and compliance tasks. The person will be highly sufficient in medical facilitator regulations as they relate to the complexities of HIPAA, Medicare, Medicaid, private health insurance and Code of federal Regulations (CFR) applied to medical billing practices. The position will work closely with the KCFD Medical Officer, Billing and Quality Assurance Management staff and CFO, as well as contracted vendors to ensure compliance in Departmental policies and procedures of all applicable healthcare legislation, specifically as it relates to the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Medicare, Medicaid, and other private health insurances rules regulations.

Duties include:

• Supervises and oversees responsibilities of KCFD billing divisional local union represented staff.
• Collaborates with the billing manager of KCFD staff to perform periodic random internal audit of claims activity for billing division and its data systems to ensure compliance for ambulance billing as it relates to the Code of Federal Regulation (CFR).
• Identifies potential HIPAA security and regulatory compliance risks and makes recommendations to mitigate risks.
• Assists divisional assigned representatives in the preparation and/or presentation of informational material for billing divisional compliance reporting relative to the departments compliance policies and procedures.
• Utilizes knowledge of research methods and techniques in quality assurance plans,
• Ensures that the compliance code of ethics application and review techniques of KCFD divisional compliance related licensures, training materials, regulatory updates, certifications, and contracts are up to date.
• Facilitates training materials related to compliance for KCFD billing staff.
• Reviews and inspects all divisional training as it relates to compliance prior to staffing implementation.
• Responsible for compliance of policies, procedures, monitoring adherence to the rules for the preservation of sensitive information.
• Monitors and implements the codes specified in departmental regulations under the overall supervision of the KCFD CFO.
• Performs statistical studies for the departments compliance to ensure all divisions remain compliant to legislative, State, and Federal regulations.
• Utilizes needed extensive knowledge of Health Insurance Portability and Accountability Act (HIPAA), Medicare, Medicaid, and private health insurances rules as well as Code of federal Regulations (CFR) as they apply to Medicare, Medicaid and private insurance billing.
• Translates intent of regulations into written policies and procedures applicable to the department’s function and compliance with associated complex State, Federal and private rules pertaining to healthcare.

REQUIRES an accredited Master’s degree in public or business administration, urban or regional planning, economics, organizational psychology/development, project management, or geography; OR an accredited Bachelor's degree and 1 year of professional experience in public or business administration, corporate/municipal finance, research, accounting, planning, project/program management or geographical information system analytics. Preference given to those who maintain KCFD compliance in knowledge of Health Insurance Portability and Accountability Act (HIPAA), Medicare, Medicaid, and private health insurances rules as well as Code of federal Regulations (CFR) as they apply to Medicare, Medicaid (CMS) and private insurance billing.

URGENT!!! CRITICAL RECRUITMENT INFORMATION

Applications and/or resumes are evaluated on the information received by the application deadline. Please ensure that your application or resume clearly demonstrates how you meet the minimum qualifications for the position for which you are applying, this includes providing all relevant educational dates and a detailed description of relevant work experience, including months/years of employment. Applications and/or resumes may not be considered if information is incomplete.

In order for a resume to be used in lieu of an application the resume must have been submitted online via the City’s Applicant Tracking System.

Positions requiring a high school diploma/GED certificate must be obtained from a school/program accredited by the Department of Education and recognized by the U.S. Secretary of Education.

The minimum education requirement for positions that allow for experience equivalency for an accredited degree is a high school diploma. Unless otherwise specified, an accredited degree must be obtained from a college or university listed with the U.S. Department of Education and recognized by the U.S. Secretary of Education.

For positions with a salary grade of EX6 or higher that require an accredited degree, qualifying professional experience must be obtained AFTER the accredited degree is obtained.

Successful completion of a pre-employment criminal history/background check is required for all positions. Some positions require a post offer drug screen and/or physical.

If appointed, non-residents must obtain residency inside Kansas City, Missouri's city limits within nine months.

The City of KCMO is an equal opportunity employer that values diversity and inclusion in the workplace. The City is committed to providing a workplace environment for its employees and citizens free from discrimination based on race, color, sex (including pregnancy), national origin, religion, age, disability, marital status, genetic information, sexual orientation, or gender identity. For more information, please see our EEO Policy

The City of KCMO is committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation because of a disability for any part of the employment process, please call 816-513-1908 or send an e-mail to accommodations@kcmo.org.

If claiming military veterans' preference points, you must attach a copy of your DD-214 or a DD-256 (for reservists). To claim veterans’ points you must have served 180 days of regular active duty service and be discharged or released under honorable conditions during peacetimes or 90 days of active duty service, one (1) day during “wartime” and a last discharge or release under honorable conditions. (DOD) 38 U.S. Code § 4211).