Medicare Compliance Specialist - Denver Colorado

Company: VirtualVocations
Location: Denver, Colorado
Posted On: 02/01/2025

A company is looking for a Claims Medicare and Regulatory Compliance Specialist.



Key Responsibilities

Conducts assessments of business processes and state requirements to enhance operational efficiency and compliance
Delivers actionable reports and analysis to stakeholders, identifying trends and root causes
Manages regulatory oversight activities, including market conduct exams and compliance with CMS reporting requirements


Required Qualifications

Bachelor's Degree in a related field or equivalent business experience
5+ years of related claims experience, particularly in quality or compliance oversight
Experience with CMS Section 111 reporting and identifying missing eligibility data
Applicable claims, compliance, risk, and/or legal designations are desirable
Proficient in developing workflows for compliance reporting and monitoring processes More...

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