About the company
This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Compliance Analyst based in United States.
Responsibilities
- Conduct audits of healthcare providers and vendors to support fraud, waste, and abuse monitoring and compliance programs
- Lead or support FWA investigations, research providers and relevant regulatory alerts, and investigate internal and external compliance concerns
- Support the administration and continuous improvement of the corporate compliance program, including assigning compliance training and maintaining complete, auditable records
- Collaborate with credentialing, quality assurance, network management, security, and other cross-functional teams to address compliance concerns and implement corrective actions
- Partner with health plan customers on business audits, including developing, documenting, tracking, and responding to audit requests
- Monitor licensing requirements and state regulatory filings to help ensure ongoing compliance
- Conduct security risk assessments, present findings to the compliance committee, and collaborate with security teams to resolve identified issues
- Monitor regulatory and industry developments affecting healthcare and DMEPOS operations and recommend updates to processes, policies, and controls
- Build strong working relationships with internal stakeholders and external partners while providing responsive, high-quality compliance support
- Take ownership of assigned audits and projects, manage multiple priorities, and deliver accurate work within established deadlines
Requirements
- Bachelor’s degree required
- At least 3 years of experience in Special Investigation Unit processes, healthcare compliance, fraud investigations, or a comparable role
- Previous healthcare industry experience is required; experience with DMEPOS is strongly preferred
- Strong knowledge of fraud, waste, and abuse, healthcare credentialing, medical billing, HIPAA, and related healthcare legislation and regulations
- Working knowledge of medical billing processes and healthcare compliance practices
- Strong analytical capabilities, including experience working with data and advanced proficiency in Microsoft Excel; Tableau experience is a plus
- Excellent attention to detail and the ability to interpret complex information and communicate it clearly to technical and non-technical audiences
- Strong written and verbal communication skills, with the ability to work effectively with clients, executives, and cross-functional stakeholders
- Excellent organizational and project management skills, with the ability to manage multiple priorities, meet tight deadlines, and follow assignments through to completion
- High standards of integrity, ethics, discretion, and professional judgment when handling sensitive and confidential information
- A service-oriented mindset and the ability to build trusted-advisor relationships with key stakeholders
- Collaborative approach and demonstrated ability to work effectively across teams and organizational levels
- Self-starter who is comfortable working independently while remaining proactive in communication and escalation
Conditions
- Annual salary of $85,000
- Competitive compensation and annual bonus program
- Remote work opportunities across eligible U.S. locations
- 401(k) retirement plan with company match
- Company-paid life insurance
- Company-paid short-term disability coverage, subject to location restrictions
- Medical, dental, and vision benefits
- Paid time off, sick time, company holidays, and floating holidays
- Paid parental leave
- Quarterly company-sponsored events
- Health and wellness programs
- Career development and professional growth opportunities
- Inclusive, collaborative work environment with opportunities to partner across healthcare, compliance, legal, security, and operational functions