Compliance Analyst

Integra Partners•Troy, MI

35d•$85,000 - $85,001•Remote

About The Position

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 committed to excellence in our work, a growth mindset and continuous improvement, and cultivating a deep understanding of the healthcare industry. 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 and investigate and audit provider billing and UM auth request practices. Some of your key responsibilities will be researching providers, reviewing CMS alerts, as well as keeping up-to-date and managing 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. If you are a self-starter, service-oriented, and able to interpret and communicate complex information, then this is an excellent opportunity as a next step in your career.

Requirements

At least three years’ experience in Special Investigation Unit processes or similar roles
Previous healthcare experience is required
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
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
A 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

Nice To Haves

DMEPOS experience preferred
Experience with Tableau a plus

Responsibilities

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