Compliance Coordinator

About Medical Review Institute of America

Established in 1983, Medical Review Institute of America (MRIoA) is a clinically-focused, technology-enabled utilization management organization delivering expert clinical reviews, regulatory advice, and actionable insights to healthcare entities. Our team's commitment to excellence drives our success.

Benefits

• Competitive salary package
• Healthcare, vision, and dental insurance
• Generous 401k matching program
• Paid vacation, personal days, and holidays
• Opportunities for personal growth and training
• Collaborative team environment with events and prizes throughout the year

Position Overview

This staff-level role is responsible for managing corporate-wide compliance activities focusing on regulatory compliance and accreditation standards. The Compliance Coordinator supports the Compliance Department while ensuring the organization meets all accreditation and regulatory filings as required.

Key Responsibilities

• Assist in administering the corporate compliance program components as directed
• Maintain regular communication and provide updates to the Vice President, Chief Compliance Officer, and Compliance Manager
• Coordinate and document staff training on regulatory compliance and accreditation standards and manage the company's Learning Management System
• Support the review and maintenance of corporate policies and procedures
• Prepare and file applications, reports, and documents for state authorities and accrediting bodies
• Conduct monthly exclusions checks for employees and contractor reviewers
• Compile and present required compliance reports and submissions to regulatory and accreditation agencies
• Assist with employee and reviewer orientation and ongoing education regarding compliance requirements
• Support internal and external audits by gathering, reviewing, and analyzing relevant data, and assist in follow-up actions including reporting, monitoring, and correction plans
• Ensure adherence to Medicare Part D guidelines and Fraud, Waste, and Abuse policies
• Provide assistance with legal matters such as record requests, subpoenas, depositions, and information releases
• Support investigation and reporting of privacy and security incidents as requested
• Contribute to Quality Management initiatives and participate in complaint handling processes
• Maintain flexible work hours and participate in company meetings and committees
• Perform additional duties as assigned

Qualifications and Skills

• Exceptional customer service, analytical, and critical thinking abilities
• Strong oral and written communication skills with excellent interpersonal capacity
• Keen attention to detail and excellent organizational aptitude
• Ability to handle multiple priorities under pressure and meet deadlines
• Comprehensive knowledge of managed care, utilization review accreditation standards including URAC and NCQA, and multi-state regulatory environments
• Familiarity with company clients, products, departments, and workflows
• Proficient in Microsoft Word; familiarity with Excel and PowerPoint preferred
• Ability to maintain confidentiality and objectivity
• At least two years of experience in healthcare, health insurance, or managed care preferred
• Experience with compliance or quality improvement in healthcare settings preferred
• Experience conducting small group or individual training preferred
• Research experience is advantageous

Education

• High School Diploma required
• Bachelor’s degree preferred

Work Environment

This role requires desk work involving computer, telephone, and basic office equipment use. It is designed to be a remote, work-from-home position.

Diversity and Legal Compliance

MRIoA values diversity and provides equal employment opportunity regardless of race, color, religion, gender, age, national origin, veteran status, disability, sexual orientation, gender identity or expression, marital status, genetic information, or any other legally protected status.

The company is a drug-free workplace; candidates must pass a background check and drug screen before employment. Employees must comply with HIPAA regulations and company policies for maintaining confidentiality and protecting sensitive health information.

California Consumer Privacy Act (CCPA) - For California Residents

• Personal sensitive information collected may include name, address, phone number, email, social security number, signatures, online identifiers, IP address, driver’s license or state ID, and passport number.
• Applicants have the right to access and request correction of their data by contacting the company.