Regulatory Submissions Coordinator

Collabrios delivers purpose-built software solutions that unify the entire care journey. By combining deep industry expertise with cutting-edge technology, we empower care providers to streamline operations while delivering exceptional care. From PACE programs to government agencies, our integrated technology infrastructure supports the full spectrum of care delivery.

Job Overview

The Regulatory Submissions Coordinator plays a key role in managing PACE regulatory file submissions, corrections, and resubmissions. This position ensures submissions are completed accurately and on time, while also supporting internal collaboration and troubleshooting across teams. The ideal candidate brings technical knowledge, attention to detail, and a commitment to service excellence with both internal and external stakeholders.

Key Responsibilities 

• Regulatory Submissions: Submit encounter files to CMS and applicable state agencies.
• Error Resolution: Work to identify and resolve submission errors efficiently.
• Monitoring & Reporting: Track submission rates, rejections, and return file activity.
• Data Uploads: Upload return files to PACE organizations and PDAC.
• Communication: Collaborate clearly and promptly with internal teams and external plan stakeholders.
• Coding Accuracy: Apply appropriate coding to all regulatory submissions.
• Recordkeeping: Maintain accurate and complete digital records of submission activity.
• Analysis: Complete monthly analysis of submissions, rejections, and resubmissions.
• Resubmission Prep: Compile and organize records for resubmission following corrective action.
• Claim Review: Review and analyze claim coding for completeness and accuracy.
• Process Improvement: Contribute to the development and enhancement of operational procedures.
• Compliance: Adhere to CMS/state regulations and internal policies; complete all required training.
• Risk Flagging: Escalate any suspected fraud or abuse concerns to leadership.
• Cross-Functional Support: Assist in resolving challenges across claims, payments, enrollment, and provider contracts.
• Client Engagement: Participate in internal and client-facing calls as needed.

What You Bring

Required: 

• High school diploma or equivalent required
• 1–3 years of experience in a health plan, insurance company, or third-party administrator
• Understanding of Medicare, Medicaid, and PACE programs
• Familiarity with encounter submissions and capitated payment structures
• Ability to manage multiple priorities in a fast-paced environment
• Strong analytical and critical thinking skills
• Proficiency in Microsoft Office and comfort using digital tools
• Effective verbal and written communication skills
• Ability to work independently while maintaining alignment with team goals
• Experience supporting policy and procedure updates across departments

Bonus points if you have: 

• Coursework or training in medical terminology, coding, or claims processing
• Experience preparing files for CMS/state compliance audits or data reviews
• Familiarity with submission rejection codes and resolution workflows
• Previous experience supporting internal QA or regulatory reporting
• Exposure to working with PDAC systems or similar submission platforms

What We Offer

At Collabrios Health, we’re committed to fostering a workplace that supports your well-being, growth, and ability to make a meaningful impact. Here’s what you can expect when you join our team:

• A connected, virtual-first culture with a collaborative, mission-driven team
• Competitive health benefits, including medical, dental, and vision coverage
• 401(k) with company contribution
• Generous paid time off, including 15 PTO days, 2 floating holidays, and 6 sick days
• Flexibility and trust—we empower our team to manage their schedules and work in ways that support their lives
• Opportunities for learning, mentorship, and professional development
• A values-driven environment where diverse perspectives are welcomed and purpose guides our work

We’re committed to building a diverse and inclusive workplace.
Collabrios is an equal opportunity employer. We welcome candidates from all backgrounds, identities, and experiences. If you’re excited about this role but your experience doesn’t align perfectly with every qualification, we encourage you to apply anyway. You may be the right candidate for this or other roles.