Compliance Operator The Compliance Operator is responsible for executing and validating compliance-related decisions within the illumend platform while supporting operational workflows and the customer support desk. This role combines insurance compliance review responsibilities with operational support
Essential Duties and Responsibilities: - Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data. - Enter coded data into a system
Essential Duties and Responsibilities: - Provides customer service for basic and routine inquiries and problems via multiple possible channels (i.e. telephone, emails, web chats, or written letters). - Calls are predominantly routine, but may require deviation