Remote Compliance Analyst: FWA & Audits Expert

Integra Partners; Central City (KY); On-site; USD 77,000 - 94,000; Full time

Benefits offered by this job

401(k) match

Life insurance

Disability coverage

Medical, Vision, and Dental benefits

PTO

Parental Leave

Sick Time

Holidays and events

Wellness programs

Career development opportunities

Job summary

Integra Partners is hiring a Compliance Analyst to join the Legal team. You will monitor for Fraud, Waste, and Abuse (FWA), audit provider and vendor practices, and support the Corporate Compliance program.

This role collaborates with credentialing, QA, and network management, and interfaces with health plans on audits and responses. You will review CMS alerts, investigate compliance concerns, ensure regulatory filings are up to date, and participate in security risk assessments with the data

Qualifications

• Bachelor’s degree required.
• Three years of experience in Special Investigation Unit processes or similar roles; healthcare experience required, DMEPOS experience preferred.
• Strong understanding of fraud, waste and abuse, healthcare credentialing, medical billing, HIPAA and related legislation.
• Experience with data analysis and advanced Excel; Tableau a plus.
• Strong attention to detail and ability to interpret and communicate complex information.
• Effective written and verbal communication skills.
• Ability to manage multiple projects and meet tight deadlines.
• Commitment to high quality client service and building trusted advisor relationships.

Responsibilities

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

Skills

FWA monitoring

Audits

Compliance program

Training records

Credentialing collaboration

Data analysis

Excel

Tableau

Education

Bachelor's degree

Tools

Excel

Tableau

Job description

Integra Partners is hiring a Compliance Analyst to join the Legal team. You will monitor for Fraud, Waste, and Abuse (FWA), audit provider and vendor practices, and support the Corporate Compliance program.

This role collaborates with credentialing, QA, and network management, and interfaces with health plans on audits and responses. You will review CMS alerts, investigate compliance concerns, ensure regulatory filings are up to date, and participate in security risk assessments with the data