Contractual Compliance Coordinator

Job Summary

A company is looking for a Contractual Compliance Coordinator.

Key Responsibilities:

• Conduct routine monitoring and audits of procedures, including billing systems audits and client audits
• Ensure compliance with client contract criteria and Medicare Advantage requirements
• Assist with claims reporting, appeals, and UM challenges

Required Qualifications:

• 3-5 years of experience in healthcare or managed care industry
• 1-3 years of Medicare Advantage HMO experience
• 3 years of auditing experience in healthcare industry
• CPT and ICD coding knowledge
• Proficiency in Microsoft Office products