Compliance Specialist - CGS

BlueCross BlueShield of South CarolinaNashville, TN
$19 - $34Hybrid

About The Position

CGS is seeking a Compliance Specialist to conduct internal desk audits. This will be a hybrid position reporting out of the Nashville, Tennessee office. Conducts annual vulnerability risk assessment audits for division. Assists management in preparation and conduct of management control reviews. Provides guidance to management and employees as needed. Performs detailed investigations of allegations/compliance issues and maintains tracking and quality databases. May develop, implement, and present ongoing training, and conduct periodic surveys and awareness initiatives. May be required to submit regulatory reporting data according to government schedule. Evaluates corrective action plans to ensure adequacy. Performs research and prepares reports and material as required.

Requirements

  • Two years health insurance, Medicare, compliance or audit, investigations or corporate-level related experience.
  • Bachelor's Degree.
  • Microsoft Office.

Nice To Haves

  • Acts as liaison with other areas.
  • Analyzes information.
  • Conducts audits.
  • Drafts contracts.
  • Leads negotiation sessions.

Responsibilities

  • Conducting investigations, preparing reports, work papers, and performing vulnerability assessments to recognize and identify potential compliance issues.
  • Providing guidance to management and employees as needed.
  • Developing and presenting compliance training, updating/maintaining or approving program/training material, and responding to compliance related questions.
  • Conducts annual vulnerability risk assessment audits for division.
  • Assists management in preparation and conduct of management control reviews.
  • Performs detailed investigations of allegations/compliance issues and maintains tracking and quality databases.
  • May develop, implement, and present ongoing training, and conduct periodic surveys and awareness initiatives.
  • May be required to submit regulatory reporting data according to government schedule.
  • Evaluates corrective action plans to ensure adequacy.
  • Performs research and prepares reports and material as required.

Benefits

  • Subsidized health plans, dental and vision coverage
  • 401k retirement savings plan with company match
  • Life Insurance
  • Paid Time Off (PTO)
  • On-site cafeterias and fitness centers in major locations
  • Education Assistance
  • Service Recognition
  • National discounts to movies, theaters, zoos, theme parks and more
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