Operations Regulatory Specialist providing analytical support and leadership for compliance deliverables in healthcare operations. Ensuring all regulatory project requirements are met on time.
Responsibilities
Provide analytical support and leadership for Operations projects
Ensure all regulatory and compliance deliverables are met
Collaborate with Operations departments
Monitor and prioritize IT tickets for Operations
Assist with reporting and processes tied to regulatory deadlines
Educate and train Business Partners on operations functions
Research and resolve provider claim issues and escalations
Requirements
Bachelor’s degree or equivalent years of relevant work experience required
Minimum of two (2) years of healthcare operations environment is required
Regulatory and/or compliance experience is preferred
Advanced level experience in Microsoft Word, Excel and PowerPoint
Data analysis and trending skills
Demonstrated understanding of claims operations specifically related to managed care
Advanced knowledge of coding and billing processes, including CPT, ICD-9, ICD-10 and HCPCS coding
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