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Compliance Specialist - Medicare​/Medicaid

Job in Clifton, Passaic County, New Jersey, 07015, USA
Listing for: Alliant Insurance Services
Full Time position
Listed on 2026-10-03
Job specializations:
  • Business
    Regulatory Compliance Specialist
Salary/Wage Range or Industry Benchmark: 90000 - 130000 USD Yearly USD 90000.00 130000.00 YEAR
Job Description & How to Apply Below
SUMMARY

Responsible for providing expert guidance to internal and external customers by conducting technical compliance research and drafting summary responses to issues affecting complex regulatory compliance. Completes annual risk assessments of downline call centers, acquired partners, and internal SMS departments. Corresponds to carrier audits as assigned.

This is a remote role if located outside of 50 miles from the Omaha, NE office

Hybrid schedule if located within 50 miles of the Omaha office

ESSENTIAL DUTIES AND RESPONSIBILITIES
  • Researches complex compliance issues using agreed sources; provides concise timely technical responses citing appropriate source material.
  • Collaborates in monitoring and reviewing regulatory and legislative changes, as well as preparing appropriate responses to regulatory changes under the guidance of legal counsel; oversees review to ensure appropriate changes are implemented.
  • Stays abreast of industry trends and recommends/implements changes to internal company processes, as needed.
  • Identifies issues that require legal interpretation and recommends seeking formal advice from legal counsel when necessary.
  • Documents all issues and responses according to established business protocol.
  • Provides ongoing client communication to assist with day-to-day service issues.
  • Assists in completing carrier audits and risk assessments.
  • Researches and supports new initiatives to increase efficiency, profitability, productivity, and compliance.
  • Complies with agency management system data standards and data integrity (enters and maintains complete and accurate information).
  • Performs all duties in accordance with all company policies and procedures, and all federal, state and local laws, wherein the Company operates.
  • Performs other duties as assigned.
QUALIFICATIONS EDUCATION/EXPERIENCE
  • Bachelor's Degreeor an equivalent combination of education and experience
  • Five (5) or more yearsof Compliance experience in industry
  • Three (3) or more yearsof working within Federally mandated programs
SKILLS
  • Excellent verbal and written communication skills
  • Good problem solving and time management skills
  • Ability to work within a team and to foster teamwork
  • Ability to prioritize work for multiple projects and deadlines
  • Good planning, organization, and prioritization skills
  • Proficient in Microsoft Office products

#LI-MH1

#LI-REMOTE

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