Compliance Analyst

Accountabilities

• 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.

Benefits

• 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.