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Position Details

  • Position: Compliance Specialist
  • Employment Type: Full-Time
  • Location: Allentown PA

Ideal Concepts, Inc. is looking for a Compliance Specialist to assist with supporting the Company’s Compliance Program.  The Compliance Specialist position is key to ensuring our company’s compliance with company policies, carrier requirements, CMS regulations, and all other applicable federal and state laws.  In accordance with our Compliance Program, the Compliance Specialist will help intake reported compliance concerns and support the investigation and remediation of any reported compliance concerns.  

The Compliance Specialist will assist with reviewing and providing feedback on various training and marketing materials.  The Compliance Specialist will also be responsible for conducting research into a wide variety of regulatory topics, and aide with drafting and distributing responses to complaints and inquiries from clients, carriers, regulators, and other external stakeholders.

A strong candidate for this position must be highly detail-oriented with proven research and analytical skills, adaptable to change, driven to work independently with little need for supervision, and have the ability to complete work consistently with a high level of accuracy within established timelines in a fast-paced environment. 

Responsibilities:

  • Performing administrative functions as it relates to compliance activities, which require strong data processing and analytical skills.
  • Aiding in the research of regulatory requirements and compliance monitoring and assessments.
  • Assisting in internal and external compliance audits.
  • Assisting with the tracking and monitoring of procedures and practices for the general compliance and operations.
  • Executing First Tier, Downstream, and Related Entity (FDR) requirements including exclusion screening, distribution of Code of Conduct, compliance with all applicable training requirements, monitoring and auditing of downstream entities, appropriate reporting mechanisms for fraud, waste, and abuse and compliance issues, and HIPAA Privacy controls.
  • Researching and analyzing of matters related to existing and new regulatory and contractual requirements.
  • Reviewing of training and marketing materials for compliance with company policy and regulatory requirements.
  • Promoting open lines of communication, both internal and external, to effectively present department services, policies, procedures, and programs.
  • Drafting and submitting responses to external inquiries and requests.
  • Producing accurate and concise work products that require no more than minor revisions.
  • Managing multiple tasks simultaneously ensuring timely execution in a fast-paced environment.
  • Working effectively within multidisciplinary teams.

Requirements:

  • A Bachelor’s degree is required. Business Administration, Healthcare Compliance, legal/paralegal, or related preferred.
  • Experience in compliance, audit, or other risk management working experience preferred.
  • Experience in health insurance industry, health insurance compliance programs, or related fields a plus.

Skills:

  • Ability to perform at a high level of proficiency while working independently with minimal supervision.
  • Must have strong listening and comprehension skills.
  • Fast learner of complex topics with high memory retention and ability to think critically.
  • Excellent oral, written, and interpersonal communication skills.
  • Self-starter with strong work ethic, well-organized, and excellent time management to be able to multi-task, prioritize, and meet deadlines independently in a fast-paced environment.
  • Positive and self-motivated with the ability to change priorities on-demand.
  • Demonstrated ability to work well individually and in a team environment.
  • Skilled at research and problem solving.
  • Proficient in Microsoft Windows, Microsoft Excel, Microsoft Word, Microsoft PowerPoint, and Internet knowledge.

Benefits:

  • Company pays 100% of the employee's weekly premium for major medical, dental, vision, and life insurance (family members may be added for an additional cost)
  • Employee 401k Plan
  • Generous PTO policy
  • 8 paid pre-determined holidays
  • Technology-focused, fast-paced working environment
  • Professional team atmosphere with motivated, career-driven professionals as co-workers
  • Expansion and growth with one of the top health insurance marketing companies in the nation

 

This is normally an on-site position, located in Allentown, PA. In light of COVID-19 (Coronavirus), we have made temporary arrangements for our staff to be able to work remotely. We will soon return to our offices, at which time, remote work will not be an option for this position.

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