Compliance Specialist - Medicare/Medicaid

Alliant Insurance Services; Edison (NJ); Remote; USD 95,000 - 130,000; Full time

Job summary

Alliant Insurance Services is seeking a compliance professional to provide expert guidance to internal and external customers on complex regulatory issues. This remote role supports teams across locations. You will perform annual risk assessments, respond to carrier audits, and work with legal counsel on regulatory changes.

Strong communication and documentation skills are essential. The role emphasizes teamwork, data integrity, and adherence to federal, state, and local laws as part of daily

Qualifications

• Bachelor's degree or equivalent required.
• Minimum 5 years of compliance experience in the industry.
• Minimum 3 years of experience with Federally mandated programs.

Responsibilities

• Provide expert guidance on complex regulatory compliance issues to clients and internal teams.
• Conduct research using approved sources and draft concise responses citing sources.
• Perform annual risk assessments of downline call centers, acquired partners, and SMS departments.
• Coordinate with legal counsel on regulatory changes and formal interpretations.
• Document issues and responses according to company standards.
• Monitor regulatory changes and propose process improvements.
• Aid in carrier audits and risk assessments.
• Ensure data integrity within the agency management system.
• Adhere to all policies, procedures, and applicable laws.

Skills

Compliance research

Regulatory interpretation

Regulatory reporting

Communication skills

Teamwork

Education

Bachelor's Degree or equivalent

5+ years Compliance experience

3+ years Federally mandated programs experience

Job description

SUMMARY

Responsible for providing expert guidance to internal and external customers by conducting technical compliance research and drafting summary responses to issues affecting complex regulatory compliance. Completes annual risk assessments of downline call centers, acquired partners, and internal SMS departments. Corresponds to carrier audits as assigned.

This is a remote role if located outside of 50 miles from the Omaha, NE office

Hybrid schedule if located within 50 miles of the Omaha office

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Researches complex compliance issues using agreed sources; provides concise timely technical responses citing appropriate source material.
• Collaborates in monitoring and reviewing regulatory and legislative changes, as well as preparing appropriate responses to regulatory changes under the guidance of legal counsel; oversees review to ensure appropriate changes are implemented.
• Stays abreast of industry trends and recommends/implements changes to internal company processes, as needed.
• Identifies issues that require legal interpretation and recommends seeking formal advice from legal counsel when necessary.
• Documents all issues and responses according to established business protocol.
• Provides ongoing client communication to assist with day-to-day service issues.
• Assists in completing carrier audits and risk assessments.
• Researches and supports new initiatives to increase efficiency, profitability, productivity, and compliance.
• Complies with agency management system data standards and data integrity (enters and maintains complete and accurate information).
• Performs all duties in accordance with all company policies and procedures, and all federal, state and local laws, wherein the Company operates.
• Performs other duties as assigned.

QUALIFICATIONS

EDUCATION/EXPERIENCE

• Bachelor's Degree or an equivalent combination of education and experience
• Five (5) or more years of Compliance experience in industry
• Three (3) or more years of working within Federally mandated programs

SKILLS

• Excellent verbal and written communication skills
• Good problem solving and time management skills
• Ability to work within a team and to foster teamwork
• Ability to prioritize work for multiple projects and deadlines
• Good planning, organization, and prioritization skills
• Proficient in Microsoft Office products