Healthcare Regulatory Compliance Project Lead

HealthOne Alliance; Dalton (GA); On-site; USD 60,000 - 90,000; Full time

Benefits offered by this job

401K (Match)

Health Insurance

Dental Insurance

Vision Insurance

Paid Time Off

Short/Long Term Disability

Job summary

HealthOne Alliance is seeking a Regulatory Compliance Project Specialist to compile, review, and submit documentation for audits and regulatory reviews. The role supports quality assurance and privacy efforts, reporting to the Director of Quality Assurance.

Ideal candidates have experience in healthcare or health insurance, strong knowledge of federal/state regulations, and proficiency with document systems and office software.

Qualifications

• Associate degree or equivalent is required.
• 3–5 years healthcare or health insurance experience.
• Knowledge of federal and state regulations for the insurance industry.
• Experience with claim and utilization management processes.
• Preferred experience in health insurance or related field.
• Proficiency with Word, Excel, and Adobe Pro.

Responsibilities

• Maintain knowledge of federal and state regulations and reporting deadlines.
• Review and develop project plans for regulatory audits or reviews.
• Navigate and extract information from claims processing, enrollment, billing systems.
• Compile, review, and submit documents for regulatory requests.
• Develop and monitor corrective action plans as needed.
• Update and communicate compliance policies across departments.
• Support annual regulatory filings and audits as assigned by Director.
• Provide QA/administrative support for the Compliance function.
• Maintain regular attendance and HIPAA compliance.
• Support company culture and organizational values.

Education

Associate degree or equivalent

Three to five years healthcare or health insurance experience

Working knowledge of federal and state regulations for the insurance industry

Working knowledge of claim and utilization management processes

Preferred experience in health insurance or related field

Tools

Microsoft Word

Microsoft Excel

Adobe Pro

Job description

HealthOne Alliance is seeking a Regulatory Compliance Project Specialist to compile, review, and submit documentation for audits and regulatory reviews. The role supports quality assurance and privacy efforts, reporting to the Director of Quality Assurance.

Ideal candidates have experience in healthcare or health insurance, strong knowledge of federal/state regulations, and proficiency with document systems and office software.