Remote Contractual Compliance Coordinator

Overview

The Remote Contractual Compliance Coordinator will ensure the accuracy of reporting and compliance with financial claims processing requirements in the healthcare sector.

In Short

• Conduct routine monitoring and audits of procedures.
• Ensure compliance with client contract criteria.
• Generate and submit required Commercial claims reporting.
• Prepare for annual Health Plan audits.
• Confirm pricing accuracy in fee tables.
• Monitor processes to detect fraud and waste.
• Assist in auditing and submitting appeals.
• Run access queries for administrative purposes.
• Exercise independent judgment in significant matters.
• Perform other duties as assigned.

Requirements

• 3-5 years of experience in healthcare or managed care.
• 3 years auditing experience in the healthcare industry.
• Knowledge of CPT and ICD coding.
• Understanding of Medicare requirements.
• Advanced proficiency in Microsoft Office.
• Ability to problem solve and make decisions.
• Thorough understanding of healthcare compliance requirements.
• Ability to meet deadlines and prioritize tasks.
• Strong communication skills.
• Must be organized and detail-oriented.

Benefits

• Fully remote work environment.
• Comprehensive Medical, Dental, and Vision plans.
• 401(k) plan with employer match.
• Life and Disability insurance.
• Flexible Time Off.
• Paid parental leave.
• Resources for professional growth and development.