Contractual Compliance Coordinator

As a Contractual Compliance Coordinator, you will ensure the accuracy of the required reporting and procedural and financial claims processing requirements set forth by the client and Health Plan contract requirements for the Value Based Care lines of business. This position is responsible for regulatory and contract compliance in the managed care lines of business. You will conduct routine monitoring and audits of procedures, including billing systems audits, Encounter submission audits, and client audits. You will understand and stay current with client contract criteria and requirements ensuring client services are compliant. The role involves generating and submitting all required Commercial claims reporting. The role requires preparing for the annual Health Plan audits.