Compliance Specialist - Medicare/Medicaid

Alliant Insurance Services; Omaha (NE); Hybrid; USD 70,000 - 110,000; Full time

Job summary

Alliant Insurance Services in Omaha, NE seeks an experienced Compliance professional to guide internal and external stakeholders through regulatory requirements and diligences. You will conduct risk assessments, respond to complex issues with sourced materials, and support audits of downline centers and partners, working remotely from outside office or hybrid near office.

Responsibilities include researching complex issues, monitoring regulatory changes, documenting processes, and supporting

Qualifications

• Bachelor's degree or equivalent combination of education and experience.
• 5+ years of compliance experience in the industry.
• 3+ years of experience with Federally mandated programs.
• Excellent verbal and written communication skills.
• Strong problem solving and time management abilities.

Responsibilities

• Research complex compliance issues and provide concise technical responses.
• Monitor regulatory changes and draft appropriate responses under legal guidance.
• Keep up with industry trends and recommend process improvements.
• Identify issues needing legal interpretation and seek formal advice when needed.
• Document issues and responses according to company protocol.
• Provide ongoing client communication to assist with day-to-day service issues.
• Assist in carrier audits and risk assessments.
• Support new initiatives to improve efficiency, profitability, productivity, and compliance.

Skills

Excellent verbal and written comms

Problem solving

Team collaboration

Prioritize multiple projects

Planning and organization

Proficient in MS Office

Education

Bachelor's Degree or equivalent

5+ years compliance experience

3+ years federally mandated programs

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