Managed Care Compliance Coordinator

A company is looking for a Remote Managed Care Claims Compliance Coordinator. Key Responsibilities Conduct routine monitoring and audits of billing systems, encounter submissions, and client audits Ensure compliance with client contract criteria and prepare for annual Health Plan audits Generate and submit required Commercial claims reporting and assist with auditing responsibilities 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 Ability to work independently and as part of a team, with strong organizational skills

Apr 17, 2025 - 18:57

A company is looking for a Remote Managed Care Claims Compliance Coordinator. Key Responsibilities Conduct routine monitoring and audits of billing systems, encounter submissions, and client audits Ensure compliance with client contract criteria and prepare for annual Health Plan audits Generate and submit required Commercial claims reporting and assist with auditing responsibilities 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 Ability to work independently and as part of a team, with strong organizational skills