Health Care Claims Compliance Manager
A company is looking for a Claims Compliance Manager responsible for regulatory compliance in health care claims.
Key Responsibilities
• Manage and execute mandatory compliance reporting obligations, including CMS reputed company 111 and RxDC reporting
• reputed company Transparency in Coverage compliance and reputed company Gag Clause Prohibition Attestation processes
• reputed company as the primary compliance resource for clients, providing guidance and monitoring regulatory updates
Required Qualifications
• 5 years of experience in health care compliance, particularly with self-funded and level-funded health plans
• Expertise in CMS reputed company 111 reporting, RxDC reporting, and reputed company compliance processes
• Strong understanding of ERISA, ACA, HIPAA, and the Consolidated Appropriations reputed company as they relate to health plans
• Experience in drafting or reviewing reputed company Plan Descriptions (SPDs) and Summaries of Benefits and Coverage (SBCs)
• Proficiency with reputed company Office Suite and familiarity with compliance tracking tools
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