Regulatory Compliance Manager, RHIA/RHIT/CCS-P
Location: Greenville, NC
Job Type: Direct Hire
Company: Physicians East, PA
Salary: Pay frequency -Semimonthly - salary is commensurate with experience.
Category: Non-Provider
Job Description Apply Now
The Regulatory Compliance Manager (RHIA/RHIT/CCS-P) plays a crucial leadership role within the healthcare regulatory services team, providing oversight to ensure compliance with all relevant coding, billing, and documentation regulations. This individual is responsible for the daily operational supervision of the regulatory services department, including the effective management of staff, processes, and quality assurance measures. The Regulatory Compliance Manager serves as a subject matter expert in regulatory compliance, ensuring the organization adheres to the latest federal and state requirements, and maintains high standards across all coding and billing operations. Working collaboratively with physicians, coders, and other stakeholders, this position leads initiatives in provider documentation education and coder training, with a focus on continuous improvement and risk adjustment code selection. This is a full-time opportunity for candidates seeking to advance their careers in healthcare compliance management.
The Regulatory Compliance Manager, RHIA/RHIT/CCS-P, is entrusted with the responsibility of interpreting, implementing, and monitoring the latest coding and documentation standards. This role requires an advanced understanding of healthcare regulations, as well as the ability to lead a team in delivering accurate, timely, and compliant medical coding and billing services. The manager is tasked with developing and executing educational programs for both providers and coders, ensuring comprehensive understanding and application of risk adjustment, productivity, quality reviews, and reporting requirements. The manager also provides direct support for the auditing education program, reviewing work assignments, and managing quality reviews to maintain regulatory compliance.
Located in North Carolina, this position offers professionals the opportunity to work in a dynamic healthcare environment known for its commitment to patient care and regulatory excellence. The Regulatory Compliance Manager, RHIA/RHIT/CCS-P, is responsible for staying abreast of ongoing changes in legislation, payer requirements, and compliance standards, ensuring the organization is positioned for continued success in a rapidly evolving industry. Candidates will benefit from a collaborative culture, access to ongoing professional development, and the opportunity to make a meaningful impact on healthcare delivery outcomes in the region.
Regulatory Compliance Manager, RHIA/RHIT/CCS-P - Summary- Leads regulatory compliance and coding operations in a healthcare setting
- Supervises staff and oversees the quality of regulatory services
- Acts as the primary expert on federal and state regulatory agency requirements
- Develops, implements, and maintains provider and coder education programs
- Ensures adherence to medical billing, coding, and documentation best practices
- Manage daily professional and facility coding services, ensuring accuracy and compliance
- Oversee the implementation and distribution of coding and documentation updates
- Request and manage new CPT/HCPCS codes and annual ICD-10-CM updates within the practice management system
- Revise encounter forms in response to coding or procedural changes
- Remain up-to-date on legislative, regulatory, and payer coding requirements
- Supervise hiring, training, and performance evaluations of staff
- Monitor workflow and assign work priorities for coding teams
- Review medical records and encounter forms for documentation and coding accuracy
- Provide regular analysis and reporting to physicians and leadership
- Educate providers and staff on compliance audit findings and corrective actions
- Support new provider onboarding with targeted coding and documentation education
- Serve as the liaison for external audit requests (OIG, CMS, RAC, CERT, HEDIS, Risk, etc.)
- Implement changes resulting from audit findings
- Coordinate with other departments to ensure smooth operational transitions for coding-related changes
- Competitive salary based on experience and qualifications
- Comprehensive benefits package available
- Opportunities for professional growth and continuing education
- Supportive and collaborative work environment
- Bachelor’s Degree in Health Information Services, Business Administration, or related field required
- Minimum five years of healthcare experience, with two to three years in management, coding, audit, and reimbursement programs
- Current certification as RHIA, RHIT, or CCS-P is required
- Strong analytical, organizational, and leadership skills
- Ability to deliver high-quality training and educational programs on coding topics
- Comprehensive knowledge of state and federal healthcare regulations
- Residency in North Carolina required
- Experienced in healthcare regulatory compliance and medical coding management
- Adept at interpreting and implementing complex regulatory requirements
- Proven ability to lead teams and foster a culture of compliance and continuous improvement
- Strong communicator, capable of educating both providers and coders
- Detail-oriented, analytical, and committed to upholding high standards of quality
- This full-time role supports the organization’s mission to deliver exceptional healthcare services while maintaining regulatory compliance and operational excellence
- Opportunities exist for advancement and professional development within the regulatory and compliance field
- Working in North Carolina provides access to a vibrant healthcare community and a supportive professional network
Physicians East is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
If you are a compliance-driven professional with a passion for healthcare excellence, we encourage you to apply for the Regulatory Compliance Manager, RHIA/RHIT/CCS-P position by clicking the job application button. Take the next step in your career and join a team dedicated to improving healthcare outcomes through regulatory leadership and innovation.