Claims Compliance Coordinator

About Us

All Care To You is a Management Service Organization providing our clients with healthcare administrative support. We provide services to Independent Physician Associations, TPAs, and Fiscal Intermediary clients. ACTY is a modern growing company which encourages diverse perspectives. We celebrate curiosity, initiative, drive and a passion for making a difference. We support a culture focused on teamwork, support, and inclusion. Our company is fully remote and offers a flexible work environment as well as schedules. ACTY offers 100% employer paid medical, vision, dental, and life coverage for our employees. We also offer paid holiday, sick, birthday, and vacation time as well as a 410k matching plan. Additional employee paid coverage options available.

Job Purpose

The Claims Compliance Coordinator supports the Claims Department by assisting with compliance audits, process reviews, and regulatory monitoring to ensure claims operations meet internal standards and external requirements. This role helps identify compliance risks, tracks corrective action plans, and supports training and reporting efforts to maintain accuracy, quality, and compliance across the claims function.

Duties and responsibilities

• Assist in conducting internal claims audits and quality reviews for accuracy, timeliness, and adherence to policies and regulations.
• Support audit scheduling, data collection, and documentation of audit findings.
• Track and monitor corrective action plans and follow-ups to ensure timely resolution of compliance issues.
• Assist in maintaining and updating claims compliance logs, audit reports, and reference materials.
• Help monitor state, federal, and client-specific regulatory requirements impacting claims operations.
• Collaborate with the Claims and Compliance teams to communicate audit outcomes and process improvements.
• Assist in the preparation of compliance summaries and reports for management review.
• Support training and awareness initiatives on claims compliance requirements and best practices.
• Maintain confidentiality and handle sensitive information with professionalism.
• Participate in special projects, system updates, or workflow enhancements as assigned.

Qualifications

• Associate or Bachelor’s degree in Business, Healthcare Administration, or related field preferred, or equivalent work experience.
• 1–3 years of experience in claims processing, auditing, or compliance support required.
• Basic understanding of claims operations and healthcare compliance standards.
• Knowledge of HIPAA and general regulatory requirements preferred.
• Strong attention to detail, accuracy, and organizational skills.
• Proficiency with Microsoft Office Suite (Excel, Word, Outlook) and data entry systems.
• Effective written and verbal communication skills.
• Ability to prioritize multiple tasks and work independently in a fast-paced environment.
• Commitment to maintaining confidentiality and professional integrity.