Job Closed

This listing is no longer active.

Senior Workers' Compensation Compliance Analyst

Location

United States

Posted

63 days ago

Salary

$65K - $70K / year

Seniority

Senior

Bachelor Degree5 yrs expEnglish

Job Description

Senior Workers' Compensation Compliance Analyst

Reliant

• Assist with reviewing state fee schedule rules, guidelines, regulations, and/or statutes for changes or compliance risks with reimbursement • Draft second level reconsideration letters • Assist with drafting and responding to state disputes • Determine if the second level reconsideration request requires a medical coder or clinician for audit • Work with the Director of Policy and Strategy Operations or the equivalent role to assist in implementing system changes for risk mitigation in Workers’ Compensation fee schedules or gap logic • Provide consultation internally or externally where appropriate • Provide internal training where required for compliance • Assist in the development of compliance processes and procedures • Partner with other business units to ensure compliance with implementing, adopting, or expanding on the rules and/or regulations, including but not limited to policies, procedures, and contracts • Responsible for handling high level appeals – either based on the client or dollar threshold • Establish special reimbursement policies for identified TIN’s • Other duties as assigned or requested • Responsible for handling negotiation with attorneys for state disputes

Job Requirements

  • 5+ Years with current or former healthcare fraud, compliance, and/or legal experience.
  • 3+ Years working with various medical reimbursement methodologies.
  • 3+ Years understanding medical coding and/or billing patterns and/or practices.
  • Knowledge of limited liability in property and casualty insurance
  • Basic understanding of treatment parameters and coding
  • Strong research skills
  • Comfort with reading fee schedule rules, regulations, and statutes
  • Strong oral and written communication
  • Good judgment, initiative, and discretion in confidential or sensitive matters
  • Self-starter with the ability to independently work urgently approaching deadlines and in a team
  • Creative thinking and effective risk mitigation abilities with strong decision-making skills
  • Strong analytical abilities
  • Strong computer skills and experience with relevant software
  • Excellent communication and presentation
  • Strong critical thinking, analytical, and problem-solving
  • Good interpersonal and organizational
  • Strong written and oral communication skills.
  • Intermediate or Advanced knowledge of Excel, PowerPoint, and Word.

Benefits

  • Comprehensive medical, dental, vision, and life insurance coverage
  • 401(k) retirement plan with employer match
  • Health Savings Account (HSA) & Flexible Spending Accounts (FSAs)
  • Paid time off (PTO) and disability leave
  • Employee Assistance Program (EAP)

Related Categories

Related Job Pages

More Compliance Jobs

PICPA logo

Compliance Program Coordinator

PICPA

Building a Stronger Profession Together.

Compliance63 days ago
Full TimeRemoteTeam 11-50H1B No Sponsor

• Completes the administrative aspects of the AICPA Peer Review Program in accordance with the AICPA requirements • Monitors and completes administrative cases in PRIMA to ensure benchmark compliance • Provides administrative support to firms and reviewers for input of data and materials into PRIMA • Performs timely follow-up on late peer review submissions and scheduling cases • Creates, organizes, and maintains peer review files • Monitors and follows up with firms regarding hearing cases in PRIMA • Invoices and tracks high-risk surcharges • Assists the Peer Review Administration Manager with administrative tasks and special projects • Provides administrative support to the Peer Review Administration Manager and the Professional & Technical Standards Team • Assists in the development and maintenance of training documentation

United States
iT1 logo

Compliance Manager

iT1

Everybody works better together!

Compliance63 days ago
Full TimeRemoteTeam 51-200Since 2003H1B No Sponsor

• Develop, maintain, and enforce compliance programs aligned with relevant standards (e.g., ISO, SOC 2 Type 2, GDPR, CMMC, NIST, CSF) consistent with the types of frameworks referenced across internal compliance dashboards. • Monitor regulatory updates and ensure policies and processes remain current. • Lead internal and external audits; prepare evidence and coordinate responses. • Ensure documentation aligns with legal and regulatory requirements, leveraging document control best practices. • Conduct ongoing risk assessments and collaborate with IT/Security teams to identify vulnerabilities — echoing risk assessment processes. • Develop mitigation plans, track corrective actions, and report risk posture to leadership. • Maintain centralized compliance dashboards and metrics. • Develop, revise, and publish corporate policies, procedures, and standards. • Ensure employees and vendors follow defined processes and frameworks. • Own library management and workflow processes. • Oversee training programs to ensure compliance with required regulations. • Partner with HR and department leads to improve compliance culture. • Track and report training completion, certifications, and recurring requirements. • Manage documentation repositories, version control, and audit trails. • Maintain readiness for customer, regulatory, and certification audits. • Produce and maintain evidence of compliance on demand. • Work closely with IT, Security, Legal, Client Success, and Operations teams. • Serve as a compliance subject matter expert in client discussions when needed. • Support incident response processes and post incident compliance documentation.

Arizona
Job Closed
MediSpend logo

Director, Compliance Services

MediSpend

MediSpend solutions are designed to empower life sciences companies to grow their business compliantly.

Compliance63 days ago
Full TimeRemoteTeam 51-200H1B No Sponsor

• Maintain deep, current expertise in U.S. and global life sciences compliance requirements related to HCP/HCO engagements, interactions, and transparency reporting • Serve as the primary compliance advisor for SE customers, providing guidance on regulatory interpretation, risk mitigation, and industry benchmarking • Anticipate compliance trends, emerging regulations, and evolving industry expectations; translate updates into actionable internal recommendations • Develop and maintain an expert-level understanding of the Stakeholder Engagement product—including configuration, workflows, data dependencies, reporting logic, and upcoming roadmap features • Evaluate how product enhancements, defects, or configuration choices affect customer compliance obligations, data integrity, and operational workflows • Partner closely with Product and Engineering to provide compliance input on roadmap planning, requirement definition, and release readiness • Work closely with Implementation and Customer Success teams to ensure customers are configured and supported in a manner consistent with compliance expectations and best practices • Support Sales as the compliance SME during demos, RFPs, prospect discussions, and conference participation • Contribute to the design and delivery of internal training programs, playbooks, and knowledge-based content to elevate organizational expertise on compliance and SE product requirements • Build trusted, long-term relationships with customers, acting as their strategic compliance advisor and escalation point for complex issues • Proactively engage customers to understand evolving business needs, pain points, and strategic objectives; translate insights into product or process improvements • Participate in key customer meetings, governance forums, and business reviews to reinforce alignment and demonstrate product and compliance leadership • Lead or participate in specialized compliance engagements, including assessments, audits, policy reviews, customized training, and best-practice consultations • Represent the organization at industry conferences, webinars, and professional associations to strengthen brand reputation and support commercial growth • Develop thought-leadership content (whitepapers, presentations, guidance documents) to support customers and internal teams

United States
$150K - $175K / year
Job Closed
Benepass logo

Senior GRC Analyst

Benepass

We help companies take care of their people.

Compliance63 days ago
Full TimeRemoteTeam 11-50H1B No Sponsor

• Maintain and improve information security policies, standards, procedures, control documentation, and related governance materials. • Help map policies and controls to frameworks such as SOC 2, ISO 27001/27002, HITRUST, NIST CSF 2.0, and other customer, regulatory, or security requirements. • Support policy exceptions, risk acceptances, remediation tracking, control owner follow-ups, and recurring governance workflows. • Support SOC 2, ISO 27001, and HITRUST readiness, audit preparation, evidence collection, auditor coordination, and audit response management. • Maintain recurring evidence-gathering and control testing workflows, helping ensure controls operate consistently across the business. • Track audit findings, control gaps, remediation plans, owners, due dates, and closure evidence. • Support risk assessments, control gap assessments, internal reviews, and maintenance of the risk register. • Translate technical and security risks into clear business language, including mitigations, ownership, timelines, and residual risk. • Own or support customer security questionnaires, RFP security sections, due diligence requests, and trust or compliance documentation. • Maintain reusable questionnaire content, approved responses, compliance artifacts, and customer-facing assurance materials. • Support employee security awareness programs and create clear internal guidance for policies, controls, and compliance responsibilities. • Support vendor security reviews, third-party risk assessments, remediation tracking, risk acceptance documentation, and vendor compliance evidence. • Use GRC platforms such as Vanta, Drata, Thoropass, Secureframe, or similar tools to improve evidence collection, control monitoring, task tracking, reporting, and repeatable compliance operations.

United States
$130K - $160K / year