Coordinator, Compliance (Remote)

About the Role

We are looking for a Compliance Coordinator to join our growing team and serve as a departmental support person for Compliance and PI/QM Functions. This role is based in our Phoenix, AZ office but is remote.

Responsibilities

• Assists in the monitoring of business and operations activities for compliance with internal audit processes and external health plan and regulatory rules and regulations.
• Uploads monthly, quarterly, and annual reports to secure sites while maintaining high accuracy, timeliness, and security of the data.
• Performs detailed examinations of audit documentation.
• Coordinates deliverables for internal/external audits, CAPs, Compliance, and PI/QM projects.
• Coordinates annual policy reviews, makes policy revisions as directed, and keeps policies organized, revised, and updated in compliance with regulatory and specific contract requirements.
• Researches, updates, and assists in tracking licenses specific to state guidelines, including clinician licenses.
• Stays up to date with regulatory changes relevant to healthcare and assists with updates as needed.
• Compiles data and creates pivot tables in Excel.
• Works well under deadlines and meets required timeframes.

Requirements

• 2 years of administrative experience in a health plan, medical facility, or related field.
• 2 years of experience in Customer Service, Billing/Claims, Project Management, or a related environment (preferred).
• High school diploma or GED equivalent.

Skills

• Healthcare industry experience and knowledge of medical terminology.
• Knowledge of health plan regulatory reports such as ODAG, NCQA/URAC, ICD-10 coding, medical terminology, and EMR Systems (helpful).
• Previous internal audit experience (preferred).
• Proficiency in Microsoft Office Applications (Excel, PowerPoint, Adobe, Word).
• Ethical and trustworthy.
• Excellent writing skills.
• Knowledge of HIPAA regulations and guidelines.
• Organized, detail-oriented, and able to multitask.
• Project management skills (preferred).
• Excellent verbal and written communication skills.
• Critical thinking and problem-solving skills.
• Able to work in a team environment and independently.

Office Location: 2415 E. Camelback Rd., Suite 700, Phoenix, AZ 85016 (Remote)