[Hiring] Compliance Analyst @Integra Partners

Role Description

The Legal team at Integra Partners works cross-functionally to help achieve our mission of reducing friction in healthcare. We are committed to working collaboratively, transparently, and efficiently to provide exceptional legal and compliance services to our internal stakeholders, health plans, and providers. We are hiring a Compliance Analyst to be an integral member of the Legal team and ensure we meet and exceed all our compliance obligations.

In this role, you will bring your previous compliance experience and knowledge to:

• Monitor for FWA issues
• Investigate and audit provider billing and UM auth request practices
• Research providers and review CMS alerts
• Manage compliance risks that impact our business and the DMEPOS industry

You will work closely with our Compliance Manager, Payer Division and partner with individuals at all levels of the company.

Qualifications

• Bachelor’s degree
• At least three years’ experience in Special Investigation Unit processes or similar roles; previous healthcare experience is required, DMEPOS experience preferred
• Strong understanding of fraud waste and abuse issues, healthcare credentialing, medical billing, HIPAA, and related legislation
• Experience with data analysis and excellent user of Excel; experience with Tableau a plus
• Strong attention to detail and able to interpret and communicate complex information
• Effective written and verbal communication skills
• Working knowledge of medical billing processes
• Excellent organizational skills, ability to manage multiple projects at once, follow through, and meet tight deadlines
• Commitment to provide high quality client service and a strong desire to build trusted advisor relationships with key clients and executives
• Ability to manage and handle sensitive and confidential information with the highest levels of integrity, ethical standards, discretion, and sound judgment
• Team player able to collaborate across various teams and levels and form strong working relationships

Requirements

• The primary focus of this role will be to conduct audits of vendors and healthcare providers in support of our FWA monitoring processes
• Run the Fraud, Waste, and Abuse investigation processes
• Support the administration of the company’s Corporate Compliance program
• Assign and monitor compliance training and keep detailed, auditable records
• Collaborate with our credentialing, quality assurance, and network management teams to address any concerns and implement change as needed
• Partner with health plan customers on audits of our business, draft and track audit processes and responses
• Investigate compliance concerns and issues internally and externally
• Ensure we are up to date with licensing and other filings with state agencies
• Conduct Security Risk Assessments and present results to the compliance committee
• Work closely with our data security staff to address security issues that arise
• Reports to our Compliance Manager, Payer Division

Benefits

• Competitive compensation and annual bonus program
• 401(k) retirement program with company match
• Company-paid life insurance
• Company-paid short term disability coverage (location restrictions may apply)
• Medical, Vision, and Dental benefits
• Paid Time Off (PTO)
• Paid Parental Leave
• Sick Time
• Paid company holidays and floating holidays
• Quarterly company-sponsored events
• Health and wellness programs
• Career development opportunities
• Remote Opportunities