Fractional CoCM Billing Compliance & Audit Lead (CPMA required)

About the role
We run a fast-growing care management program billed under partner clinic TINs across a mixed payer population. We need an expert to tighten CoCM billing yield while keeping documentation audit-proof as we scale from ~24 clinics to 100+.

The right candidate will be able to convert this into a full-time role with equity, and grow with the company. Looking to hire ASAP.

What you’ll own

• Design and audit CoCM and CCM billing workflows, including appropriate patient stratification between programs.

• Define clear, defensible criteria for assigning patients to CoCM vs CCM (and transitions over time).

• Build “gold standard” documentation templates and checklists for 99492/99493/99494, 99490, 99439, and related codes as applicable.

• Design simple, audit-proof time capture and attribution workflows across care team members.

• Create and run a QA sampling plan with feedback loops for care teams and clinic billers.

• Partner with clinic RCM teams to reduce denials and improve yield across mixed payer contracts.

• Build a yield dashboard: eligible → enrolled → track assigned → minutes captured → billed → denied → paid (by clinic and payer).

Must-haves

• CPMA required; CPC or CCS/CCS-P strongly preferred

• Proven experience auditing/coding CoCM / BHI (not just CCM or general E/M)

• Comfort determining when patients belong in CoCM vs CCM and documenting that decision defensibly.

• Can clearly explain the top reasons CoCM claims fail and how to prevent them

• Comfortable working cross-clinic with varying workflows and getting to standardization fast

Nice-to-haves

• Payer audit/recoupment defense experience

• Experience building training programs for care teams

• Familiarity with MA + commercial payer quirks for CoCM-like programs

To apply (required)
Send resume/LinkedIn plus a short note answering:

1. “Top 5 CoCM audit failure modes I see”

2. “How I would set up time capture + QA to prevent them”