Medicare Compliance Specialist

A company is looking for a Claims Medicare and Regulatory Compliance Specialist. Key Responsibilities Oversee accurate and timely Section 111 reporting for Medicare Collaborate with claims teams to identify and address gaps in claimant eligibility data Develop and maintain workflows for CMS reporting, ensuring compliance with guidelines Required Qualifications Bachelor's Degree in a related field or equivalent business experience 5+ years of related claims experience in a quality or compliance oversight role Applicable compliance, risk, and/or legal designations such as ARM, CRCMP, or similar Preferred: JD or Paralegal certification Process improvement certification (i.e., Six Sigma) and/or project management certification (i.e., PMP)

Feb 15, 2025 - 00:26

A company is looking for a Claims Medicare and Regulatory Compliance Specialist. Key Responsibilities Oversee accurate and timely Section 111 reporting for Medicare Collaborate with claims teams to identify and address gaps in claimant eligibility data Develop and maintain workflows for CMS reporting, ensuring compliance with guidelines Required Qualifications Bachelor's Degree in a related field or equivalent business experience 5+ years of related claims experience in a quality or compliance oversight role Applicable compliance, risk, and/or legal designations such as ARM, CRCMP, or similar Preferred: JD or Paralegal certification Process improvement certification (i.e., Six Sigma) and/or project management certification (i.e., PMP)