Compliance Analyst

at  Arkansas Blue Cross and Blue Shield

JOB SUMMARY

The Regulatory Compliance Analyst conducts comprehensive regulatory analyses which include the review, summarization, and dissemination of compliance reports and data. Incumbent must remain abreast of the health insurance industry, to include identification and interpretation of new and/or revised regulations.

EDUCATION

Bachelor’s degree in related field. In lieu of degree, five (5) years’ health insurance, healthcare, compliance, legal or equivalent experience will be considered.

EXPERIENCE

Minimum three (3) years’ related experience in any combination of the following areas: compliance, regulatory, legal and/or claims processing, and legal research and writing,
Previous experience in a healthcare environment preferred.
Knowledge of laws and/or regulations in the area of compliance.

ESSENTIAL SKILLS & ABILITIES

Written comprehension
Problem solving
Applied research
Process information
Organizing
Standards compliance
Decision making
Information collection
Critical thinking
Interpersonal communication
Analze information
Documenting/recording information
Planning activities
Interpersonal relationships
Written expression
Oral communications
Oral comprehension
Prioritization

SKILLS

Analyze Information, Applied Research, Critical Thinking, Decision Making, Documenting/Recording Information, Information Collection, Interpersonal Communication, Interpersonal Relationships, Oral Communications, Oral Comprehension, Organizing, Planning Activities, Prioritization, Problem Solving, Process Information, Standards Compliance, Written Comprehension, Written Expression

SECURITY REQUIREMENTS

This position is identified as level three (3). This position must ensure the security and confidentiality of records and information to prevent substantial harm, embarrassment, inconvenience, or unfairness to any individual on whom information is maintained. The integrity of information must be maintained as outlined in the company Administrative Manual.

ADA REQUIREMENTS

1.1 General Office Worker, Sedentary, Campus Travel - Someone who normally works in an office setting or remotely and routinely travels for work within walking distance of location of primary work assignment

RESPONSIBILITIES

Assists with special projects and administrative duties, when needed., Coordinates the completion of or creates critical filing documents/templates and key documentation within the timeframe dictated by regulatory agencies; and develops analytics reports., Performs other duties as assigned, Remains abreast of health insurance industry standards and monitors the regulatory environment to identify business vulnerabilities, conduct risk assessments, and recommend process changes., Researches, analyzes, interprets, and monitors files to determine, demonstrate and maintain adequacy in compliance with mandated state and federal regulations., Works collaboratively offering regulatory guidance as it pertains to audits, updates and/or changes to content, rules, policy and/or regulations. Analyzes, documents, compiles and distributes resources to impacted departments and/or customers.

SEGREGATION OF DUTIES

Segregation of duties will be used to ensure that errors or irregularities are prevented or detected on a timely basis by employees in the normal course of business. This position must adhere to the segregation of duties guidelines in the Administrative Manual.