Healthcare Compliance Coordinator

Job Summary

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