Employer Industry: Healthcare Services

Why consider this job opportunity:
- Comprehensive medical coverage with low copays and free telemedicine services
- 401(k) Plan with a 100% match on 3% to 9% of pay
- Employee Stock Purchase Plan with 10% off employer stock
- Flexible work from home arrangement
- Generous education assistance program, including tuition and certification support
- Paid time off, paid family leave, and a variety of additional benefits

What to Expect (Job Responsibilities):
- Create, revise, and submit claims compliance reporting to internal and external contacts
- Coordinate audit logistics, prepare audit reports, and gather requested documents
- Track and manage inbound claims grievances and provider dispute resolutions
- Serve as the primary contact for health plan auditors and providers
- Assist other departments with compliance activities as needed

What is Required (Qualifications):
- Bachelor’s degree or equivalent work experience
- Minimum of three (3) years of experience in a claims operations position
- Five (5) years of previous experience in a managed care organization
- Two (2) years of experience with claims compliance reporting/audits preferred

How to Stand Out (Preferred Qualifications):
- Experience in healthcare compliance and audit processes
- Familiarity with managed care regulations and reporting requirements
- Strong analytical and organizational skills
- Excellent communication and interpersonal skills

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