MEDICAL MANAGEMENT COMPLIANCE SPECIALIST - MEDICAL MANAGEMENT (2 POSITIONS)- JOB POSITION #2019-171
- Date Posted:
- Full Time
- OPEN UNTIL FILLED Redlands Monday - Friday 8:00a.m. - 5:00p.m.
Management Compliance Specialist coordinates all Medical Management compliance
activities with contracted health plans and regulatory entities such as CMS,
DMHC, and DHCS. The Compliance Specialist has the primary responsibility for
ensuring timely and accurate data is collected, validated, and submitted to
various clients, providers, and health plans based on regulatory requirements
and contractual agreements. The Compliance Specialist also coordinates all
compliance auditing activities with the Compliance RNs, and all levels of
Medical Management leadership.
High School diploma or equivalent. Bachelor’s degree
or higher in health care related field preferred. Two years of broadly based,
multi-tasking clerical/secretarial experience. Basic knowledge of data
collection and validation process. At least two years of experience in a
medical, managed care or health care setting. Possess a basic knowledge of
CPT/ICD codes preferred.