Remote Compliance Analyst—FWA & Healthcare Audits

Integra Partners; Charlotte (NC); Hybrid; USD 70,000 - 90,000; 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 holidays and floating holidays

Remote Opportunities

Job summary

Integra Partners is hiring a Compliance Analyst to join the Legal team. You will monitor for Fraud, Waste, and Abuse, investigate provider billing practices, and audit UM authorization requests.

You’ll work with the Compliance Manager, Payer Division, and cross-functional partners to manage risks in the DMEPOS space. Within 90 days, you’ll initiate provider audits, research FWA events, and respond to plan questions.

Qualifications

• Bachelor’s degree required or equivalent experience.
• Minimum three years in SIU or similar roles with FWA background.
• Experience with data analysis and Excel; Tableau is a plus.

Responsibilities

• Conduct audits of vendors and healthcare providers for FWA monitoring.
• Run Fraud, Waste and Abuse investigation processes.
• Assist in administration of Corporate Compliance program.
• Track and document compliance training and maintain auditable records.
• Collaborate with credentialing, QA, and network teams to address concerns.
• Support health plan audits and respond with defined processes.
• Investigate internal and external compliance issues.
• Perform Security Risk Assessments and present to the compliance committee.
• Coordinate with data security staff to address issues.

Skills

Special Investigation Unit processes

Fraud, Waste and Abuse understanding

Data analysis

Excel

Tableau

Healthcare credentialing

HIPAA knowledge

Strong organizational skills

Auditing

multitasking

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, investigate provider billing practices, and audit UM authorization requests.

You’ll work with the Compliance Manager, Payer Division, and cross-functional partners to manage risks in the DMEPOS space. Within 90 days, you’ll initiate provider audits, research FWA events, and respond to plan questions.