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MM
Fractional
Head of Compliance (Part-Time)
Mira Mace · US · Remote
Pay
Rate not listed
About the role
Mira Mace is a venture-backed healthcare company helping Medicare patients navigate care with technology and people-centered navigation. You'll own the regulatory posture as the company scales, operating as a professional corporation and management services organization. This hands-on, senior part-time role sets policies, reviews work, trains the team, and handles regulatory questions. You'll ensure coding, billing, documentation, and structure hold up to CMS, OIG, state and payer scrutiny.
What you'll do
- •Keep PC-MSO arrangement compliant with management services agreements and corporate practice of medicine rules state by state
- •Own privacy and security program including policies, risk assessments, BAAs, workforce training, and breach response
- •Audit use of Medicare codes against documentation and time requirements before claims go out
- •Review revenue cycle practices end to end including eligibility, claims, denials, appeals, and cost-sharing collection
- •Track regulatory changes in Physician Fee Schedule, NCCI edits, OIG guidance, and payer policy
- •Build and run compliance program including policies, training, monitoring, audits, and hotline
What they're looking for
- •7+ years in healthcare compliance with Medicare Part B billing and coding at the center
- •Hands-on experience with a PC-MSO or similar physician-practice management structure
- •Deep working knowledge of HIPAA, Anti-Kickback Statute, Stark, and False Claims Act
- •Experience with revenue cycle operations including claims, denials, appeals, and overpayment refunds
Skills
Medicare and Medicaid ComplianceHealthcare Coding and BillingHIPAAAnti-Kickback StatuteStark LawPC-MSO StructuresRevenue Cycle OperationsCare Management Services
Found on jobs.ashbyhq.com. Link checked Nov 9. Marquee links to the company's own application. We are not the employer.