healthcare compliance officer

White Grape Community Services

Job SummaryWhite Grape Community Services is seeking a highly skilled and detail-oriented Compliance Officer to oversee and ensure adherence to all applicable healthcare regulations, ethical standards, and internal policies within our outpatient mental health clinic. The ideal candidate will have strong knowledge of healthcare compliance, behavioral health regulations, financial oversight, and risk management. This role is essential in supporting our mission to provide high-quality, ethical, and compliant mental health services to the community.The Compliance Officer will be responsible for developing and maintaining compliance programs, conducting internal audits, monitoring regulatory changes, and promoting a culture of integrity and accountability across clinical, administrative, and financial operations.Responsibilities<ul><li>Develop, implement, and maintain compliance policies and procedures aligned with healthcare and behavioral health regulations, including HIPAA, HITECH, CMS guidelines, Medicaid/Medicare requirements, and state mental health regulations.</li><li>Conduct internal compliance audits to assess adherence to clinical documentation standards, billing practices, privacy requirements, and operational policies.</li><li>Monitor compliance with financial and accounting standards related to healthcare reimbursement, grant funding, and payer requirements.</li><li>Oversee regulatory and payer reporting processes, ensuring accuracy, completeness, and timely submission.</li><li>Manage compliance tracking systems and utilize healthcare and financial software to monitor, analyze, and report compliance metrics.</li><li>Identify potential fraud, waste, and abuse risks related to billing, coding, and service delivery; recommend and implement corrective actions.</li><li>Stay current on changes in healthcare laws and regulations, including HIPAA, Medicaid/Medicare rules, behavioral health licensing standards, and accreditation requirements.</li><li>Collaborate with leadership and staff to strengthen internal controls and risk management practices using established compliance and control frameworks.</li><li>Provide ongoing compliance training and guidance to clinical and administrative staff, including privacy, documentation, billing, and ethical standards.</li><li>Support external audits, payer reviews, and regulatory inspections by preparing documentation and serving as a liaison with auditors and regulators.</li><li>Investigate compliance concerns or incidents and oversee corrective action plans when necessary.</li></ul>Qualifications<ul><li>Bachelor&rsquo;s degree in Healthcare Administration, Accounting, Finance, Compliance, or a related field; advanced degree preferred.</li><li>Professional certifications such as CHC (Certified in Healthcare Compliance), CPA, CIA, or CAMS are a plus.</li><li>Extensive knowledge of HIPAA, HITECH, Medicaid/Medicare regulations, behavioral health compliance standards, and healthcare billing and coding practices.</li><li>Proven experience in healthcare or behavioral health compliance, internal audits, and regulatory reporting.</li><li>Strong understanding of healthcare financial concepts, reimbursement models, and internal controls.</li><li>Experience with healthcare compliance software, electronic health records (EHRs), and financial systems.</li><li>Excellent analytical skills with experience in fraud prevention, risk assessment, and corrective action planning.</li><li>Ability to interpret complex healthcare regulations and translate them into practical, effective policies and procedures.</li><li>Strong communication and interpersonal skills to train staff, collaborate with leadership, and interact with regulators or external auditors.</li></ul>Why Join White Grape Community ServicesThis position offers a meaningful opportunity to play a critical role in protecting client privacy, ensuring ethical care delivery, and maintaining regulatory compliance in a mission-driven mental health organization. The Compliance Officer will directly contribute to the integrity, sustainability, and quality of services provided to our community.Job Type: Part-timeExpected hours: 20 per weekWork Location: Hybrid remote in Portland, OR 97209

Compliance Officer

CPA CLINICS

Job Description: Medical Compliance Officer (Doctor)Location: DHA, Lahore (On‑site) Experience Required: Minimum 5 yearsPosition OverviewWe are seeking an experienced Medical Compliance Officer (Doctor) to join our team on‑site in DHA, Lahore. This role will support our clinics in New York by ensuring medical documentation compliance, reviewing clinical notes, performing medical coding, and preparing records for billing and claims processing. In addition, the role will involve holistic care coordination for chronic care patients, making it a vital link between providers, patients, and billing teams. The position requires proficiency in CureMD EMR software for documentation, coding, and workflow management.Key Responsibilities<ul><li>Medical Compliance Oversight: Ensure all clinical documentation adheres to U.S. healthcare compliance standards (HIPAA, CMS, payer guidelines).</li><li>Notes Review: Audit and review patient notes for accuracy, completeness, and compliance with medical and legal standards.</li><li>Medical Coding: Assign appropriate ICD‑10, CPT, and HCPCS codes to patient encounters to ensure accurate billing and claims submission.</li><li>Billing Readiness: Prepare documentation so that claims can be processed promptly and correctly.</li><li>Claims Support: Collaborate with billing teams to resolve discrepancies, denials, or coding issues.</li><li>Telehealth Documentation: Support providers during virtual visits by reviewing notes, coding appropriately, and ensuring compliance for telehealth encounters.</li><li>Holistic Chronic Care Support: Assist in developing and maintaining care plans for patients with chronic conditions (e.g., diabetes, hypertension, COPD). Document lifestyle factors, medication adherence, and preventive care measures to support long‑term management.</li><li>Provider Support: Work closely with physicians and healthcare providers to clarify documentation requirements and improve compliance workflows.</li><li>Training &amp; Guidance: Provide ongoing education to clinical staff regarding documentation standards, compliance updates, and coding best practices.</li><li>Quality Assurance: Conduct periodic audits of medical records to identify gaps, risks, or areas for improvement.</li><li>Regulatory Updates: Stay current with U.S. healthcare regulations, payer requirements, and compliance changes, and implement updates into workflows.</li><li>On‑Site Collaboration: Work directly with the compliance and administrative team to ensure smooth coordination with New York clinics.</li></ul>Qualifications<ul><li>Medical degree (MBBS or equivalent) with specialization or certification in medical compliance/coding preferred.</li><li>Minimum 5 years of experience in medical compliance, documentation review, and coding.</li><li>Strong knowledge of ICD‑10, CPT, HCPCS coding systems and U.S. healthcare billing standards.</li><li>Familiarity with HIPAA and CMS compliance requirements.</li><li>Experience in telehealth documentation and chronic care patient support preferred.</li><li>Excellent communication skills (English proficiency required; bilingual ability is a plus).</li><li>Detail‑oriented with strong analytical and problem‑solving skills.</li><li>Ability to work on‑site in DHA, Lahore and coordinate with U.S.‑based teams across time zones.</li></ul>This is an on‑site role in DHA, Lahore, with working hours aligned to U.S. clinic operations, evening &ndash; early morning Pakistan time.Job Type: Full-timePay: Rs170,000.00 - Rs220,000.00 per monthApplication Question(s):<ul><li>Do you hold a valid MBBS (or equivalent medical degree) and are you licensed/qualified as a doctor?</li><li>How many years of experience do you have in medical compliance, documentation review, and coding?</li><li>What is your understanding of HIPAA and CMS compliance requirements?</li><li>Are you proficient in ICD‑10, CPT, and HCPCS coding systems? Please give examples of coding work you&rsquo;ve handled.</li><li>Have you worked with CureMD EMR software before? If not, what EMR/EHR systems are you familiar with?</li><li>Do you have experience supporting telehealth sessions and ensuring documentation is compliant?</li><li>Have you assisted in documenting or coordinating care for chronic patients (e.g., diabetes, hypertension, COPD)?</li><li>Are you comfortable making follow‑up calls to U.S. patients for education, compliance, and chronic care support?</li><li>Are you comfortable working evening&ndash;early morning Pakistan time (aligned with U.S. clinic hours)?</li><li>Have you conducted compliance audits or trained staff on documentation and coding standards? Please share an example.</li></ul>Work Location: In person

Medical Compliance Doctor

Footprints Mental Health Counseling

Insurance Compliance Officer Footprints Mental Health Counseling, P.C. Title: Insurance Compliance OfficerDepartment: Compliance Schedule 9am &ndash; 5pm ESTRate: FlexibleThe goal of this position is to prevent insurance companies from disallowing claims due to the practice&rsquo;s failure to comply with regulatory requirements. The Compliance Officer ensures that if and when audited by any governing body, that we are in compliance with all rules and regulations. This includes the licensing board, office of Medicaid, all insurance panels, department of labor and internal revenue system. The position will mainly focus on compliance with our &ldquo;payers&rdquo;, however any compliance tasks in regards to any governing body may be asked of the compliance officer.Key ResponsibilitiesBilling &amp; Coding Compliance<ul><li>Ensure all staff members are properly educated on CPT codes, including which codes should and should not be used.</li></ul><ul><li>Monitor and address overbilling concerns, particularly related to CPT code 90837, and ensure appropriate use of 90834 when required.</li></ul><ul><li>Cancel or void claims that are billed incorrectly or reported by clients as not occurring; investigate all such incidents promptly.</li></ul><ul><li>Prevent insurance recoupment through proactive audits, education, and corrective action.</li></ul><ul><li>Address and respond to insurance company inquiries related to billing practices, overbilling, or audits.</li></ul>Oversight<ul><li>Ensure interns are billing only Medicaid or other insurances that have approved supervisee billing.</li></ul><ul><li>Confirm interns are billing under the correct CPT codes and within payer guidelines.</li></ul><ul><li>Manage supervision-related compliance, including documentation of supervision hours and licensure-related paperwork as applicable.</li></ul>*Clinical Documentation &amp; Quality Assurance<ul><li>Ensure intake sessions are conducted correctly and documented appropriately.</li></ul><ul><li>Ensure all treatment plans are active, updated at least every three months, and properly signed by clients.</li></ul><ul><li>Monitor the overall quality of clinical notes to ensure accuracy, completeness, and compliance with payer and regulatory standards.</li></ul><ul><li>Ensure all clinical documentation adheres to guidelines set forth by governing bodies, Medicaid, Optum, and other payers.</li></ul>Fraud Prevention &amp; Risk Management<ul><li>Regularly review sessions and documentation for potential fraud or unethical behavior.</li></ul><ul><li>Immediately escalate and address suspected fraud, including terminating providers when necessary and resolving issues through claim voiding and corrective action.</li></ul>Medicaid &amp; Payer-Specific Compliance<ul><li>Ensure all Medicaid cases are following Medicaid protocols and requirements.</li></ul><ul><li>Ensure adherence to Optum guidelines and any other payer-specific rules.</li></ul><ul><li>Serve as a subject matter expert on payer policies and compliance requirements.</li></ul>Policy Development &amp; Cross-Department Collaboration<ul><li>Create and maintain billing and insurance compliance best-practice guidelines for all staff.</li></ul><ul><li>Provide training and ongoing education to clinicians, interns, and administrative staff.</li></ul><ul><li>Work closely with the billing department and intake department to ensure organization-wide compliance and consistency.</li></ul>Qualifications<ul><li>Bachelor&rsquo;s degree in healthcare administration, health information management, business, or a related field required; advanced degree preferred &bull; 2+ years of experience in insurance billing, compliance, utilization review, or healthcare revenue cycle management (behavioral health preferred) &bull; Strong working knowledge of CPT codes, documentation standards, and insurance billing requirements, including Medicaid and commercial payers &bull; Demonstrated experience preventing recoupment and addressing payer audits, denials, and disallowments &bull; Ability to review clinical documentation for quality, accuracy, and compliance with payer and regulatory standards &bull; Strong understanding of insurance coverage details, including deductibles, copayments, coinsurance, and authorization requirements &bull; Ability to understand and differentiate mental health degree types and licensure levels, including interns, limited permit providers, and fully licensed clinicians (e.g., MHC Intern, MHC-LP, LMHC, LCSW, LMSW, PhD, PsyD, LMFT, etc.) &bull; Ability to understand a wide range of mental health diagnoses and treatment modalities, including but not limited to bipolar disorder, major depressive disorder, anxiety disorders, PTSD, CBT, DBT, and psychodynamic therapy &bull; Excellent attention to detail with the ability to identify compliance risks, billing errors, and potential fraud &bull; Strong organizational and documentation skills, with the ability to manage multiple cases, providers, and compliance tasks simultaneously &bull; Excellent customer service skills and a collaborative mindset, with the ability to work effectively with clinicians, interns, billing staff, intake teams, and leadership &bull; Ability to communicate clearly and professionally when providing education, feedback, and corrective guidance to staff &bull; Experience creating policies, procedures, and best practice guidelines related to billing and compliance</li></ul>Why Join Us<ul><li>Fully remote leadership role (India &amp; Philippines)</li><li>Direct impact on organizational integrity and growth</li><li>Opportunity to build and lead a compliance team</li><li>Stable, long-term position with advancement potential</li><li>Mission-driven organization focused on ethical mental health care</li></ul>How to ApplyApply through Indeed with your updated resume.Qualified candidates will be contacted for interviews.If compliance is your strength and leadership is your calling, this role gives you both.Job Type: Full-timePay: From ₹25,000.00 per monthWork Location: Remote

Insurance Compliance Officer

Amneal Pharmaceuticals

<div>Essential Functions
Assist in drafting, updating, and implementing compliance policies and procedures aligned with regulatory changes.
Ensure smooth functioning of the Compliance Program in India, in line with applicable local laws.
Develop and deliver compliance training, awareness campaigns, and communication collaterals for employees.
Review, monitor, and approve HCP/HCC/TPR-related business activities to ensure compliance with policies.
Implement and maintain internal controls to strengthen compliance governance.
Conduct quarterly compliance monitoring, identify risks, and recommend remediation measures.
Drive compliance culture initiatives through employee engagement programs.
Maintain compliance governance calendar, dashboards, and reports for senior management.
Support Third-Party Due Diligence processes and remediate identified risks.
Maintain accurate compliance records, reports, and documentation as per company policies.
Partner cross-functionally with Manufacturing, QA, QC, R&amp;D, Corporate Affairs, and other internal stakeholders to ensure compliance alignment.</div>
 <div>Education
Essential:
Degree/Certification in Compliance, Pharma Management, Business Administration, Finance, or related discipline.
Desirable:
Degree in Law (LLB/LLM).
Experience
Minimum 3&ndash;5 years of experience as a Compliance Officer in the pharmaceutical or healthcare industry.
Hands-on experience with compliance monitoring, audits, and regulatory requirements.
Exposure to international compliance standards will be an added advantage. 
Skills &amp; Competencies
Technical / Functional Knowledge:
India Compliance &amp; Regulations &ndash; Mastery
Compliance Monitoring &amp; Audit &ndash; Mastery
MS Office &ndash; Advanced
Core Competencies:
Stakeholder Management &ndash; Mastery
Communication Skills &ndash; Mastery
Organizational Capability &ndash; Mastery
Integrity &amp; Ethical Judgment &ndash; Mastery
Analytical &amp; Problem-Solving Skills &ndash; Advanced
Critical Thinking &ndash; Advanced
Behavioral Competencies:
Delivery Focus
Ownership &amp; Accountability
Cross-functional Collaboration
Cost &amp; Profitability Focus
Other Requirements
Willingness to travel as per business needs.
Strong interpersonal skills with the ability to influence and build compliance culture.</div> <div></div>

Assistant Manager, Compliance

Silver Hill Hospital

<div>We are seeking an experienced and dedicated General Counsel to join our team at Silver Hill Health. The individual in this role will provide comprehensive legal support to the Silver Hill Health system, acting as a general resource and coordinator for a wide range of areas in which legal expertise is needed. This includes but is not limited to employment law (e.g., hiring, terminations, benefits, employee relations), contracts with external vendors (e.g., drafting, editing, and vetting), contracts with insurance company payers, non-profit corporate governance and board practices, corporate structure including merges and acquisitions, brand licensing, healthcare licensing and regulation, healthcare privacy and record keeping, medical malpractice, insurance, tax, neighbor relations, and real-estate. The attorney will also oversee all management and tracking of legal documents. While the attorney should have some degree of familiarity with all these areas, they will be encouraged to reach out to enlist focused expertise where needed, e.g., on regulatory matters with our long-standing external counsel. The ideal candidate will have a strong background in healthcare law. Experience in behavioral health or addiction services is preferred, though not a requirement.
Duties/Responsibilities:
<ul><li>Provide legal advice and support to hospital administration, clinical staff, and various departments on a wide range of issues, including (but not limited to) privacy, malpractice torts/patient complaints, personnel matters, mergers acquisitions &amp; affiliations, and insurance policies.
</li><li>Ensure the hospital&rsquo;s operations comply with federal and state regulations, including (but not limited to) HIPAA, mental health laws, STARK/Anti-Kickback, and licensing requirements. Develop and implement policies to ensure ongoing compliance.
</li><li>Acts as a subject matter expert with a strong understanding of the business, legal, financial, and technical requirements of the transactions related to Silver Hill Health's lines of business.
</li><li>Negotiates contractual provisions to reflect business requirements that meet company needs and maximize revenue, flexibility and potential, while minimizing exposure and liability
</li><li>Negotiates, structures, drafts, and manages contractual documents that establish the terms and conditions of the business relationships and pricing with vendors, customers and/or partners
</li><li>Negotiates contracts, drafts terms and conditions using original text/language, and redlines contracts
</li><li>Responsible for developing and maintaining client/vendor relationships, interacting with all levels of management, and may participate in vendor management
</li><li>Responsible for creating standard, template agreements for new services and software products
</li><li>Leads the contract negotiation process and coordinates the process across several departments and areas within the organization.
</li><li>Documents issues arising during contract negotiations and recommends a viable resolution to internal management
</li><li>Provides accurate, detailed, and timely information with regards to business, legal, financial, and technical requirements to assist management in making informed business decisions
</li><li>Consults and advises senior management
</li><li>Determines and produces appropriate documents (e.g., non-disclosure agreements, trial agreements, letters of intent, agreements, schedules, BAAs etc.) as required
</li><li>Manage any legal disputes involving the hospital, working closely with outside counsel when necessary. Partner with Quality and Experience Department on management of grievances and disputes. Provide guidance on risk management and mitigation strategies.
</li><li>Conduct training sessions for staff on legal compliance, ethical issues, and best practices in healthcare law.
</li><li>Collaborate with hospital leadership to develop, implement, and review hospital policies and procedures that align with legal standards and best practices.
</li><li>Liaise with regulatory bodies, legal professionals, and other healthcare organizations to represent the hospital&rsquo;s interests and ensure best practices.
</li><li>Acquisitions, Mergers, and Affiliations.
</li><li>Privacy laws and requirements.
</li><li>Quality and Compliance of the hospital.
</li><li>Risk management, Insurance.
</li><li>Malpractice.
</li><li>Tax issues.
</li><li>Municipal issues.
</li><li>Real estate.
</li><li>Employee matters pertaining to their employment with SHH.
</li><li>General Corporate matters.
</li><li>By-Laws, Board documents, Resolutions, etc.
</li><li>Supporting outside counsel on all matters they are assigned so we can develop internal capacity.
</li></ul>Required Skills/Abilities:
<ul><li>Excellent communication, negotiation, and interpersonal skills.
</li><li>Proven ability to work collaboratively in a multidisciplinary environment.
</li><li>Strong analytical and problem-solving skills.
</li></ul>Education and Experience:
<ul><li>Juris Doctor (JD) from an accredited law school.
</li><li>Admission to the Connecticut Bar.
</li><li>At least 5 years of experience drafting, negotiating, managing and advising on matters related to contracts, including service agreements, license agreements and other transactional agreements.
</li><li>Must have familiarity with healthcare or privacy and security in relation to healthcare i.e. HIPAA Minimum of 5 years of legal experience, with a focus on healthcare law or related fields. Experience or familiarity with behavioral health law is a plus.
</li><li>Strong knowledge of federal and state healthcare regulations, including mental health statutes.
</li><li>Experience with software solutions, software licensing, intellectual property, or healthcare privacy and security a plus.
</li><li>Business process outsourcing experience a plus.
</li><li>Certified in healthcare compliance a plus.
</li></ul>Physical Requirements:
<ul><li>Occasionally lift and move up to 25 pounds.
</li><li>Ability to travel as required.
</li></ul>Silver Hill Hospital (&ldquo;SHH&rdquo;) is fully committed to equal employment and advancement opportunities for all present employees as well as for applicants in all phases of the employment process (recruitment, hiring, assignment, conditions of employment, compensation, benefits, training, promotion, transfer, discipline and termination). Therefore, except in any cases of bona fide occupational qualification or need, SHH will act without regard to race, color, religion, national origin, age, sex, marital status, status as a protected veteran, sexual orientation, gender identity or expression, pregnancy, past/present history of mental disorder, intellectual disability, physical or learning disability, genetic information or any other characteristics protected by applicable law, (unless it is shown by supervisory personnel that a disability prevents performance of the work involved or may result in undue hardship) in all aspects of the employment process and relationship. This policy is based on the understanding that an applicant is able to handle the job requirements. Employment decisions will be based on merit, qualifications and abilities.</div>

General Counsel

Medway Online Private Limited

Medway is expanding its healthcare licensing team and is looking for a DataFlow &amp; Primary Source Verification (PSV) Executive to support healthcare professionals with GCC licensing processes.Key ResponsibilitiesManage end-to-end DataFlow &amp; PSV applications Verify healthcare documents (education, license, experience, ID) Coordinate with candidates, universities &amp; authorities Handle DHA / DOH / MOH / Prometric licensing requirements Track application status and ensure timely completion Guide doctors, nurses &amp; allied healthcare professionals throughout the processRequirements1&ndash;3 years experience in DataFlow / PSV / Healthcare Licensing Graduate with healthcare background (mandatory) Strong communication &amp; attention to detail Ability to manage multiple cases and deadlines Proficiency in MS OfficeWhy Join Medway?Growing international healthcare documentation exposure Supportive &amp; professional work culture Learning and career growth opportunitiesJob Type: Full-timePay: ₹25,000.00 - ₹30,000.00 per monthWork Location: Hybrid remote in Andrews Ganj, Delhi

PSV Executives

Global Mission Support Services LLC

Job Title: HR Officer Country Location: Nauru Employment Type: Full-timeMUST BE WILLING TO RELOCATE TO THE COUNTRY NAURU. About Nauru Medical Centre: Nauru Medical Centre is a leading healthcare provider committed to delivering high-quality patient care. We are seeking a dedicated HR Officer with healthcare experience to support our staff and organizational growth.Key Responsibilities:<ul><li>Manage end-to-end recruitment, onboarding, and offboarding of medical and administrative staff.</li><li>Maintain accurate employee records, contracts, and HR databases.</li><li>Support employee relations, performance management, and staff training initiatives.</li><li>Ensure compliance with labor laws, healthcare regulations, and company policies.</li><li>Assist in payroll administration and benefits management.</li><li>Collaborate with management to implement HR strategies aligned with organizational goals.</li></ul>Requirements:<ul><li>Bachelor&rsquo;s degree in Human Resources, Business Administration, or related field.</li><li>Proven 3-5 years experience as an HR Officer or HR Generalist. Priority will be given to candidates with hospital or healthcare HR experience.</li><li>Strong knowledge of HR practices, labor laws, and healthcare regulations.</li><li>Excellent communication, organizational, and interpersonal skills.</li><li>Proficiency in HR software and Microsoft Office Suite.</li></ul>Preferred:<ul><li>HR certification (e.g., CIPD, SHRM) is an advantage.</li><li>Experience in hospital or clinic HR operations.</li></ul>Benefits:<ul><li>Competitive salary</li><li>Free Accommodation, transportation and meals</li><li>30 days annual paid leave</li><li>Healthcare coverage</li><li>Professional development opportunities</li><li>Supportive and collaborative work environment</li></ul>How to Apply: Interested candidates are invited to submit their CV and a cover letter to talent@gmss.ltd with the subject line: &ldquo;HR Officer &ndash; Nauru Medical Centre&rdquo;.Job Type: Full-timeApplication Question(s):<ul><li>Do you have experience in HR in healthcare sector or hospital? </li><li>Are you willing to be relocated to the country Nauru once we hire you?</li></ul>

HR Officer- Nauru

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