Compliance Specialist-Employee Benefits

Higginbotham • Fort Worth, TX

5d

About The Position

The Compliance Specialist ensures that organizations comply with federal, state, and local regulations related to health insurance, including HIPAA, ACA, ERISA, and CMS requirements. The role monitors regulatory changes, conducts audits, analyzes compliance data, and supports internal teams with policy development and training to reduce risk and maintain adherence to applicable laws.

Requirements

• At least 2 years of experience in health insurance, managed care, or healthcare regulatory compliance.
• Familiarity with HIPAA, ACA, CMS rules, and state insurance laws.
• Active Life and Health license required.
• Proficiency with Microsoft Excel, Word, PowerPoint, and Outlook.
• Ability to lift 25 pounds.
• Repeated use of sight to read documents and computer screens; repeated use of hearing and speech to communicate by telephone and in person; repetitive hand movements such as keyboarding, writing, and 10-key; and walking, bending, sitting, reaching, and stretching in all directions.
• Demonstrated problem-solving, attention to detail, communication, time management, collaboration, client focus, dependability, creative thinking, organizational skills, and adaptability.

Nice To Haves

• Applied Epic experience; knowledge of a similar Account Management System (AMS) is acceptable.

Responsibilities

• Monitor and interpret regulatory and legislative developments affecting health insurance and communicate impacts to relevant stakeholders.
• Assist in implementing compliance policies and procedures.
• Conduct audits and risk assessments to evaluate adherence to compliance standards.
• Analyze and report on compliance data, trends, and metrics to identify areas of risk or improvement.
• Maintain current documentation of compliance policies, training materials, and regulatory affairs.
• Provide compliance training and support to internal teams on relevant laws and policies.
• Track and manage corrective action plans for identified compliance issues.
• Maintain applicable client databases, including Compliance Dashboard and Zywave.

Benefits

• Medical, dental, vision, and prescription drug coverage.
• Supplemental benefits for physical, emotional, and financial wellbeing.
• 401(k).
• Equity incentive plan.
• Employee Wellness Program.
• Company-paid holidays and PTO.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed