Lead Claims Compliance Coordinator

Join our Claims Department as a key leader driving compliance excellence and audit readiness across the organization. The Lead Claims Compliance Coordinator oversees health plan and regulatory audits, ensures timely and accurate monthly and quarterly reporting, and serves as the primary point of contact for all compliance-related matters.

In this role, you’ll develop and maintain department policies and procedures, generate internal audit reports, review critical claims data, and keep the team informed of evolving regulations and industry standards. You’ll collaborate closely with Claims leadership and cross functional partners, Authorization, Eligibility, Contracting, IT, and more, to resolve dependencies that impact compliance and claims operations.

You will also provide guidance to operational coordinators, support corrective action planning, and help build a strong, audit-ready department. This position is ideal for an experienced claims professional with strong analytical skills, deep regulatory knowledge, and the confidence to lead, problem-solve, and support continuous improvement across the organization.