Remote Medicare Compliance Ops Manager

Allan Koba Compliance Solutions; United States; On-site; USD 85,000 - 110,000; Full time

Benefits offered by this job

Medical, dental, vision and life 보험?

Remote work

Job summary

Allan Koba Compliance Solutions is seeking a Compliance Manager, Operations to own the end-to-end lifecycle of assigned files, from intake to resolution and CMS submission. The role is highly autonomous and demands strong analytical skills and meticulous attention to detail.

The candidate will review medical records, assess claims, and prepare findings for our attorney team while maintaining direct client communications.

Qualifications

• 3-5+ years of professional experience in medical, legal, claims, insurance, or compliance settings
• Demonstrated ability to work autonomously and own complex processes end-to-end with minimal oversight
• Strong analytical judgment and ability to review medical records and claims and distill high-level findings for an attorney team
• Exceptional professional demeanor when interfacing with clients and government representatives
• Excellent writing, organizational, and communication skills
• Ability to handle multiple priorities and deadlines in a fast-paced environment
• Proficient in Microsoft Office Suite

Responsibilities

• File intake - receiving and organizing medical records and materials for a prestigious clientele and converting materials into a DMS
• File assignment - prioritizing and managing the flow of files toward timely progression
• High-level file review - conducting medical record and claim review with advanced analysis for attorney findings
• Client communication - serving as the primary point of contact with clear, case-specific updates
• Client oversight - monitoring case status and follow-ups to drive resolution and satisfaction
• Metric tracking - capturing and reporting performance metrics across the caseload
• CMS submissions - preparing and submitting accurate filings to CMS
• Government communication - corresponding with CMS and other government entities
• Correspondence - preparing and reviewing correspondence and resolving issues with knowledge of policies

Skills

Autonomy

Analytical reasoning

Medical records review

Client communication

Time management

Performance metrics

Microsoft Office

Tools

Microsoft Office Suite

DMS

CMS systems

Job description

Allan Koba Compliance Solutions is seeking a Compliance Manager, Operations to own the end-to-end lifecycle of assigned files, from intake to resolution and CMS submission. The role is highly autonomous and demands strong analytical skills and meticulous attention to detail.

The candidate will review medical records, assess claims, and prepare findings for our attorney team while maintaining direct client communications.