New

Clinic Compliance Manager

Tufts University
Minimum $106,100.00, Midpoint $132,600.00, Maximum $159,100.00
United States, Massachusetts, Boston
1 Kneeland Street (Show on map)
Apr 27, 2026
Overview Tufts University School of Dental Medicine (TUSDM) offers one of the most forward-looking educational environments in Dental Medicine in the Country. TUSDM has established a formal institutional Compliance Program to help ensure compliance with all Federal, State and Accreditation Regulations, especially those related to Anti-Kickback, Fraud and Abuse, and HIPAA Privacy and Security Regulations. The TUSDM Compliance Program provides a structure and process to disseminate legal, regulatory and policy changes to members of the TUSDM Workforce and promote an ethical, law-abiding culture. Due to the complex and ever-changing regulatory requirements, the Federal Government has mandated that Healthcare Providers and Covered Entities establish a Compliance Program that is charged with monitoring, preventing, and correcting any potential non-compliant actions or behavior. The Compliance Manager, along with the other members of the TUSDM Workforce and Compliance Team, supports the Compliance, Academic and Clinical Mission of TUSDM in this regard. This position reports directly to the TUSDM Sr. Compliance Officer, and works closely with the TUSDM Workforce, particularly the Revenue Cycle department, Clinic Administration (Clinical Affairs) Coordinator and Staff, Post-Graduate Practice Managers and the Billing, Clinic and Academic Management Staff. This is a hybrid role, with an onsite presence as needed to perform the work. The posted compensation range reflects a full-time, 35-hour work week. This role is part-time at 24 hours per week (approximately 0.68 FTE), and the actual salary will be prorated accordingly. What You'll Do The Compliance Manager will work with the TUSDM Compliance Team to develop and oversee the Compliance Audit Work Plans for the Pre-Doctoral and Post-Graduate Clinics and perform routine compliance audits of the Dental Clinics to determine medical necessity and the level of care billed for services rendered, in accordance with Medicare, Medicaid, other federal insurance programs and third-party payer regulations. The individual provides guidance, training and education and suggests corrective action plans, when applicable, to members of the TUSDM Workforce, including but not limited to, Students, Residents, Fellows, Faculty, TUSDM-sponsored Visitors, Staff and Volunteers. The Compliance Manager collaborates with Clinical Affairs, Practice Managers, the TUSDM Billing Department and other necessary entities/third party payers to identify and analyze billing, documentation and regulatory guidelines that may impact TUSDM's Compliance efforts, revenue cycle, and Academic or Research Missions. Conduct accurate and compliant compliance reviews of pertinent medical records and provider services to identify and report audit outcomes and need for coding education. Develop and recommend appropriate action plans to correct instances of non-compliance. Formulate, and update annually as necessary, appropriate billing guidelines and policies relating to providers' billing of all professional fees, both medical and dental. Develop appropriate training materials and programs to guide TUSDM's providers, clinical and administrative staff in the areas of coding and documentation. Develop and implement an effective training and education program for clinical and non-clinical staff affected by billing compliance including providers, independent contracts and other department staff Monitor pre and post billing compliance and assist in the reduction of identified problem areas utilizing audits and other risk evaluation techniques. Conducts analyses and makes recommendations as needed. Develop written reports documenting audit findings & recommendations. Compiles audit results using audit database. May conduct and participate in TUSDM meetings. Provide education and training on coding related areas to TUSDM Students, Faculty, Staff, and all Workforce Members. All other projects as requested. may conduct and participate in TUSDM meetings. Provide education and training on coding related areas to TUSDM Students, Faculty, Staff, and all Workforce Members. All other projects as requested. Ensure requests, inquiries, and/or investigations by regulatory agencies and third-party payors are effectively managed and coordinated internally. What We're Looking For Basic Requirements: Knowledge and experience typically acquired by: Bachelor's Degree 7+ years of current billing and medical coding audit work within a physician/dental practice or hospital system. Demonstrated knowledge of insurance carriers, Medicare and Medicaid reimbursement plans, commercial dental/medical, insurance coding and billing practices (third-party billing) and dental patient care systems Familiarity with ADA (dental) codes, ICD-9/10 and CPT Codes. Microsoft Word, Excel, PowerPoint, Outlook, email, internet. Coding Instructor credentials Certified Dental Coder (CDC) Preferred Qualifications: Familiar with Axium, Dentrix or Epic FYI: The posted compensation range reflects a full-time, 35-hour workweek. This role is part-time at 24 hours per week (approximately 0.68 FTE), and the actual salary will be prorated accordingly. Pay Range Minimum $106,100.00, Midpoint $132,600.00, Maximum $159,100.00 Salary is based on related experience, expertise, and internal equity; generally, new hires can expect pay between the minimum and midpoint of the range.