Remote Compliance Analyst: FWA & Audit Specialist

Integra Partners; Philadelphia (Philadelphia County); Remote; USD 65,000 - 95,000; Full time

Benefits offered by this job

401(k) retirement program with company

Company-paid life insurance

Company-paid short term disability

Medical, Vision, and Dental benefits

Paid company holidays and floating?

Remote Opportunities

Job summary

Integra Partners is hiring a Compliance Analyst to join our U.S.-based Legal team and ensure we meet all compliance obligations. You will monitor for FWA issues, investigate provider billing and UM auth practices, and support the Corporate Compliance program.

You will collaborate with the Compliance Manager, Payer Division, and cross-functional partners to conduct provider audits, research CMS alerts, and manage compliance risks affecting the DMEPOS network.

Qualifications

• Bachelor’s degree in a relevant field.
• 3+ years’ experience in Special Investigation Unit processes or similar roles; strong understanding of fraud waste and abuse, credentialing, billing, HIPAA.
• Experience with data analysis; Excel; Tableau is a plus.
• Working knowledge of medical billing processes.
• Excellent organizational skills; ability to manage multiple projects and meet deadlines.
• Commitment to high quality client service and trusted advisor relationships.
• Ability to handle confidential information with integrity and discretion.

Responsibilities

• Audit vendors and healthcare providers to support FWA monitoring.
• Run Fraud, Waste, and Abuse investigation processes.
• Support the administration of the Corporate Compliance program.
• Assign and monitor compliance training and maintain auditable records.
• Collaborate with credentialing, QA, and network teams to address concerns.
• Partner with health plan customers on audits and responses.
• Investigate compliance concerns internally and externally.
• Conduct Security Risk Assessments and present results to the compliance committee.
• Work with data security staff to address security issues.

Skills

FWA knowledge

Data analysis

Excel proficiency

HIPAA knowledge

Discretion

Education

Bachelor’s degree

Tools

Tableau

Excel

Job description

Integra Partners is hiring a Compliance Analyst to join our U.S.-based Legal team and ensure we meet all compliance obligations. You will monitor for FWA issues, investigate provider billing and UM auth practices, and support the Corporate Compliance program.

You will collaborate with the Compliance Manager, Payer Division, and cross-functional partners to conduct provider audits, research CMS alerts, and manage compliance risks affecting the DMEPOS network.