Contractual Compliance Coordinator

A company is looking for a Remote Contractual Compliance Coordinator. Key Responsibilities Conduct routine monitoring and audits of procedures, including billing systems and client audits Ensure compliance with client contract criteria and generate required Commercial claims reporting Assist in preparing for annual Health Plan audits and monitor processes for fraud detection Required Qualifications 3-5 years of experience in healthcare or managed care, including claims/reimbursement experience 3 years of auditing experience in the healthcare industry Knowledge of CPT, ICD coding, Medicare requirements, and APC Pricing Advanced proficiency in Microsoft Office products, especially Excel and Access Thorough understanding of healthcare compliance requirements at federal, state, and local levels

Apr 17, 2025 - 21:43

A company is looking for a Remote Contractual Compliance Coordinator. Key Responsibilities Conduct routine monitoring and audits of procedures, including billing systems and client audits Ensure compliance with client contract criteria and generate required Commercial claims reporting Assist in preparing for annual Health Plan audits and monitor processes for fraud detection Required Qualifications 3-5 years of experience in healthcare or managed care, including claims/reimbursement experience 3 years of auditing experience in the healthcare industry Knowledge of CPT, ICD coding, Medicare requirements, and APC Pricing Advanced proficiency in Microsoft Office products, especially Excel and Access Thorough understanding of healthcare compliance requirements at federal, state, and local levels