Physician Billing Compliance Specialist

SHIFT: Day (United States of America) Seeking Breakthrough Makers Children’s Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will inspire you to pursue passions, develop expertise, and drive innovation. At CHOP, your experience is valued; your voice is heard; and your contributions make a difference for patients and families. Join us as we build on our promise to advance pediatric care—and your career. CHOP does not discriminate on the basis of race, color, sex, national origin, religion, or any other legally protected categories in any employment, training, or vendor decisions or programs. CHOP recognizes the critical importance of a workforce rich in varied backgrounds and experiences and engages in ongoing efforts to achieve that through equally varied and non-discriminatory means. A Brief Overview This role is responsible for reviewing and analyzing billing processes, conducting documentation, coding, and billing audits, and ensuring compliance with applicable healthcare regulations for the Children’s Hospital of Philadelphia Practice Association (CHOPPA). The position serves as a core compliance and coding support resource across both inpatient and outpatient settings. The role works closely with other compliance team members, physician leadership, and operational partners, including professional billing (PB) coders, physicians, Advanced Practice Providers, residents, and fellows. Responsibilities include auditing both professional coding and provider documentation to ensure accuracy, regulatory compliance, and alignment with organizational standards. In addition to audit functions, this role provides education and guidance to providers and coders, meeting regularly with multidisciplinary groups to support compliant documentation and coding practices. The position supports all provider types and specialties, including surgery, anesthesia, critical care, and other clinical areas, with exposure across every physical area of the organization. Strong communication and presentation skills are essential, as the role requires frequent interaction with diverse clinical and coding audiences. Experience or strong interest in anesthesia and radiology coding is highly desirable! Most Relevant Required Certifications (upon hire): Certified Coding Specialist (CCS) – AHIMA or NHA, or Certified Coding Specialist–Physician-Based (CCS-P) – AHIMA, or Certified Professional Coder (CPC) – AAPC Schedule: Standard schedule, with some team members working 7:30 a.m.–4:00 p.m. Flexibility available after the first 90 days. What you will do 1. Systematically monitor, review and analyze patient medical records to determine all appropriate diagnosis and procedures performed. Provide feedback and education to providers. 2. Conduct chart audits to ensure providers are in compliance with coding and regulatory guidelines. 3. Provide feedback…