Remote Compliance Analyst – FWA & Audit Expert

Integra Partners; Yuma (AZ); Remote; USD 77,000 - 94,000; Full time

Benefits offered by this job

Annual bonus

401(k) retirement program with company

Life insurance

Health benefits

PTO

Parental leave

Sick time

Holidays

Career development opportunities

Job summary

Integra Partners is hiring a Compliance Analyst to join its Legal team and ensure adherence to compliance obligations. You will monitor for FWA issues, investigate provider billing and UM auth practices, and research CMS alerts while coordinating with cross-functional teams.

The role requires at least three years in a related SIU/healthcare context, strong data-analysis skills with Excel (Tableau a plus), and a commitment to integrity and confidentiality.

Qualifications

• Bachelor’s degree required.
• At least three years’ experience in Special Investigation Unit processes or similar healthcare roles; DMEPOS experience preferred.
• Strong understanding of fraud, waste and abuse issues, healthcare credentialing, medical billing, HIPAA and related legislation.
• Experience with data analysis and proficient in Excel; Tableau experience a plus.
• Strong attention to detail and ability to interpret and communicate complex information.
• Excellent written and verbal communication skills and knowledge of medical billing processes.
• Excellent organizational skills and ability to manage multiple projects, meet tight deadlines, and provide high-quality client service.
• Ability to handle sensitive information with integrity, discretion and sound judgment.

Responsibilities

• The primary focus is to conduct audits of vendors and healthcare providers to support FWA monitoring.
• Run the Fraud, Waste, and Abuse investigation processes.
• Support the administration of the company’s Corporate Compliance program.
• Assign and monitor compliance training and maintain auditable records.
• Collaborate with credentialing, quality assurance, and network management teams to address concerns.
• Partner with health plan customers on audits of the business, draft and track audit processes and responses.
• Investigate compliance concerns internally and externally.
• Ensure licensing and filings with state agencies are up to date.
• Conduct Security Risk Assessments and present results to the compliance committee.
• Work with data security staff to address security issues.

Skills

FWA monitoring

Audits

Data analysis

HIPAA compliance

Communication skills

Organizational skills

Cross-functional collaboration

Education

Bachelor's degree

Tools

Excel

Tableau

Job description

Integra Partners is hiring a Compliance Analyst to join its Legal team and ensure adherence to compliance obligations. You will monitor for FWA issues, investigate provider billing and UM auth practices, and research CMS alerts while coordinating with cross-functional teams.

The role requires at least three years in a related SIU/healthcare context, strong data-analysis skills with Excel (Tableau a plus), and a commitment to integrity and confidentiality.