Healthcare Compliance Auditor I

ADP, Inc.; Fairmont (WV); On-site; USD 65,000 - 95,000; Full time

Job summary

Healthcare Management Solutions, LLC is seeking a Compliance Investigator/Auditor I to support federal oversight activities related to Health Insurance Marketplace operations. Responsibilities include reviewing documentation, conducting audits and investigations, analyzing data, and documenting findings to ensure compliance with federal requirements.

Ideal candidates have experience in auditing, investigations, compliance, healthcare, or regulatory oversight, and hold a Bachelor's degree.

Qualifications

• Bachelor's Degree (Healthcare industry related preferred) or equivalent experience.
• Experience in auditing and compliance reviews.
• Ability to analyze large volumes of documentation and data.
• Excellent report writing and case documentation skills.
• Ability to manage multiple tasks in a fast-paced environment.

Responsibilities

• Review policies, procedures, and records to evaluate compliance risks.
• Analyze audit evidence and data to identify trends and concerns.
• Document findings, prepare workpapers, and develop reports.
• Monitor corrective actions and verify resolution.
• Support enrollment practices, marketing compliance, and operational compliance oversight.
• Collaborate with subject matter experts and government stakeholders.

Skills

Auditing

Investigations

Compliance

Healthcare

Insurance

Regulatory oversight

Education

Bachelor's degree

Job description

Healthcare Management Solutions, LLC is seeking a Compliance Investigator/Auditor I to support federal oversight activities related to Health Insurance Marketplace operations. Responsibilities include reviewing documentation, conducting audits and investigations, analyzing data, and documenting findings to ensure compliance with federal requirements.

Ideal candidates have experience in auditing, investigations, compliance, healthcare, or regulatory oversight, and hold a Bachelor's degree.