Healthcare Compliance Coordinator

A company is looking for a Remote Contractual Compliance Coordinator. Key Responsibilities Conduct routine monitoring and audits of billing systems and client services to ensure compliance Generate and submit required claims reporting and assist in preparing for annual Health Plan audits Monitor processes to detect fraud, abuse, or waste and participate in auditing and submitting appeals Required Qualifications 3-5 years of experience in the healthcare or managed care industry, 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 Word, Excel, and Access Thorough understanding of healthcare compliance requirements at federal, state, and local levels

Apr 23, 2025 - 00:23

A company is looking for a Remote Contractual Compliance Coordinator. Key Responsibilities Conduct routine monitoring and audits of billing systems and client services to ensure compliance Generate and submit required claims reporting and assist in preparing for annual Health Plan audits Monitor processes to detect fraud, abuse, or waste and participate in auditing and submitting appeals Required Qualifications 3-5 years of experience in the healthcare or managed care industry, 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 Word, Excel, and Access Thorough understanding of healthcare compliance requirements at federal, state, and local levels