Remote 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
• Ensure compliance with client contract criteria and prepare for annual Health Plan audits
• Generate and submit required Commercial claims reporting and assist with appeals and audits

Required Qualifications

• 3-5 years of experience in the healthcare or managed care industry, including claims/reimbursement
• 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