Claims Compliance Manager
Centivo
full-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $115,000 - $125,000 per year
About the role
- Own and execute all CMS Section 111 mandatory insurer reporting obligations
- Manage RxDC reporting under the CAA
- Prepare and submit annual PCORI fee filings
- Administer the Gag Clause Prohibition Attestation process
- Develop and maintain Preferred Networks disclosures
- Serve as the internal SME on No Surprises Act compliance
- Monitor and maintain compliance workflows
Requirements
- 5 years of experience in health care compliance
- Expertise with CMS Section 111 reporting
- Knowledge of ERISA, ACA, HIPAA, and CAA
- Experience drafting or reviewing SPDs and SBCs
- Proficiency with Microsoft Office Suite
- Understanding of self-funded health plans.
Benefits
- Offers Equity
- Offers Bonus
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
CMS Section 111 reportingRxDC reportingPCORI fee filingsGag Clause Prohibition Attestationcompliance workflowsdrafting SPDsreviewing SBCsself-funded health plans