Job Description

About the Company

Join a dynamic group of insurance regulatory consultants with a mission of protecting consumers as it relates to health care access and services. This role is remote but everything our team does is connected.

About the Role

A growing team is seeking a motivated and skilled Examiner with health insurance  and health care industry knowledge to assist with the enforcement of federal health insurance regulations such as the No Surprises Act (NSA), Transparency in Coverage, and others. The Examiner will be an integral part of the market conduct examinations team and will assist with regulator enforcement of federal regulations. This is a unique opportunity to be part of a highly important and visible project transforming the American healthcare landscape for years to come. Professionals possessing intellectual curiosity, initiative, and interest in growing their careers are encouraged to apply.

Responsibilities

• Assist with the drafting of documents necessary for completing projects, such as: requests for information (RFIs); criticisms (conclusions of non-compliance) and rebuttals to criticism responses; audit outlines and flow charts; internal communications; etc.
• Assist with organizing and analyzing RFIs production, responses to criticisms, correspondence, and other project-related items
• Review and analyze health plan and issuer records, including data and claim files
• Synthesize results of the records analysis, applying regulations to demonstrate findings of compliance or non-compliance
• Complete assigned tasks in a timely and accurate manner
• Communicate with and report to the Senior Examiner regarding project progress
• Adapt and implement changes to projects based on team needs
• Perform job duties within a matrix management structure

Qualifications

• Bachelor’s degree or 4 years work experience in health insurance or health care Compliance, Audit, or insurance operations
• Critical thinking skills and ability to determine appropriate courses of action
• Excellent time management skills
• Ability to manage multiple projects, tasks, and changing priorities efficiently
• Excellent written and oral communication
• Proficient in Microsoft Office (Word, Excel, PowerPoint, and Outlook) and Adobe Acrobat PDF and the ability to learn and apply new software programs
• Ability to perform equally as well when working independently or with a team
• Self-motivated and ability to complete tasks with minimal direction

Preferred Skills

• Auditing background
• Curious mindset
• Excellent Writing
• Strong Communication Skills

Who Should Apply

• Regulatory compliance professionals
• Health insurance industry professionals
• Health policy analysts
• Audit professionals
• Health care compliance professionals
• Individuals with extensive experience in clinical health care management

Benefits

• 401(k) and match
• Health insurance
• Dental insurance
• Vision insurance
• Life insurance
• Paid time off
• Reimbursement towards professional development, phone, and gym membership
• Vacation Bonus plan