UM Compliance & Audit Coordinator

Advanced Medical Management, Inc.; Long Beach (CA); On-site; USD 22,000 - 25,000; Full time

Benefits offered by this job

Health coverage

Vision and dental premiums

FSAs

401(k)

PTO & sick pay

Paid holidays

Tuition reimbursement

Company outings and lunches

Job summary

Advanced Medical Management, Inc. in Long Beach, CA, is seeking a UM Compliance Coordinator to support auditing, reporting, and program improvements within the Compliance team. This full-time clerical role reports to the Compliance Manager and requires strong communication and confidentiality.

The position involves audit preparation, calendar management, report generation, and collaboration with care management leaders to improve outcomes while maintaining HIPAA privacy and PHI security.

Qualifications

• One year's experience in a physician office or clinic preferred or IPA/Group UM or CM department Coordinator preferred.
• BA degree from a recognized university will be considered and trained.
• Medical terminology training or healthcare related experience preferred.
• Must be able to communicate both orally and in writing.
• Ability to apply common sense, to read and comprehend simple instructions to carry out detailed written and/or oral instructions.
• Must be able to efficiently prioritize multiple high priority tasks.
• Must have the ability to work independently and be organized with minimal supervision.
• Must maintain strict confidentially of all patient information and IPA business.

Responsibilities

• Schedules and prepares for CM/UM/QM audits
• Manages audit calendar and excel schedule
• Runs/Manages all reports as listed in the P&P
• Assist Compliance Manager, Quality Manager, and Director of Care Management to eliminate CAPs and/or operationalize process improvement techniques for better outcomes.
• May assist with automating reports
• Maintains confidentiality of all members and medical/clinical information
• Performs as necessary to any departmental changes, workload and/or emergencies
• Has understanding of Policies/Procedures
• Letter programs to ensure templates are accurate per Health Plan including but not limited to new and update information from ICE Website
• Ensures the privacy and security PHI (Protected Health Information) as outlined in AMM policies and procedures relating to HIPPA compliance
• Performs other duties as directed by Compliance Manager
• Back up support for managing the Audit Manager application for UM issues
• Back up support for creating denial letters with 8th grade language requirement

Skills

Oral and written communication

Prioritization

Independent work

Confidentiality

Education

Bachelor's degree

Medical terminology training

Job description

Advanced Medical Management, Inc. in Long Beach, CA, is seeking a UM Compliance Coordinator to support auditing, reporting, and program improvements within the Compliance team. This full-time clerical role reports to the Compliance Manager and requires strong communication and confidentiality.

The position involves audit preparation, calendar management, report generation, and collaboration with care management leaders to improve outcomes while maintaining HIPAA privacy and PHI security.