Compliance Specialist-Employee Benefits

Position Summary: The Compliance Specialist ensures that organizations comply with all federal, state, and local regulations related to health insurance, including but not limited to HIPAA, ACA, ERISA, and CMS requirements. This role involves monitoring regulatory changes, conducting audits, analyzing compliance data, and supporting internal teams with policy development and training to reduce risk and maintain adherence to applicable laws.

Essential Tasks:

• Monitor and interpret regulatory and legislative developments affecting health insurance and communicate impacts to relevant stakeholders


• Assist in the implementation of compliance policies and procedures


• Conduct audits and risk assessments to evaluate adherence to compliance standards


• Analyze and report on compliance data, trends, and metrics to identify areas of risk or improvement


• Maintain up-to-date documentation of compliance policies, training materials, and regulatory affairs


• Provide compliance training and support to internal teams on relevant laws and policies


• Track and manage corrective action plans for identified compliance issues


• Maintain applicable client databases (Compliance Dashboard, Zywave, etc.)

Core Competencies:

• Ability to Analyze and Solve Problems: Skill in recognizing challenges, exploring options, and implementing effective solutions in a timely manner


• Attention to Detail: A strong focus on completing tasks and projects accurately and thoroughly


• Communication Skills: Capable of expressing ideas clearly in both verbal and written forms and engaging with various audiences


• Timely Task Completion: Ability to finish tasks and projects efficiently, managing resources and priorities effectively


• Team Collaboration: Willingness to work together with others, promoting teamwork and supporting shared goals


• Client Focus: Dedication to understanding and addressing the needs of clients and stakeholders to ensure their satisfaction


• Dependability: Acknowledgment of the importance of being present and punctual


• Creative Thinking: Openness to suggesting new ideas and methods to improve processes and outcome


• Organizational Skills: Capability to prioritize tasks and manage multiple projects simultaneously


• Adaptability: Willingness to adjust to changing situations and priorities, showing resilience in a dynamic work environment 

Experience and Education:

• 2+ years of experience in health insurance, managed care, or healthcare regulatory compliance


• Familiarity with key regulations such as HIPAA, ACA, CMS rules, and state insurance laws 

Licensing and Credentials:

• Active Life and Health license required 

Systems:

• Proficient with Microsoft Excel, Word, PowerPoint, and Outlook


• Applied Epic experience preferred, but knowledge of similar Account Management System (AMS) is acceptable 

Physical Requirements:

• Ability to lift 25 pounds


• Repeated use of sight to read documents and computer screens


• Repeated use of hearing and speech to communicate on telephone and in person


• Repetitive hand movements, such as keyboarding, writing, 10-key


• Walking, bending, sitting, reaching and stretching in all directions

Benefits and Compensation: 

• Higginbotham offers medical, dental, vision, and prescription drug coverage


• Multiple supplemental benefits for physical, emotional, and financial wellbeing


• 401(k) and an equity incentive plan


• Employee Wellness Program 


• Company paid holidays, plus PTO 

Notice to Recruiters and Staffing Agencies: To protect the interests of all parties, Higginbotham Insurance Agency, Inc., and our partners, will not accept unsolicited potential placements from any source other than directly from the candidate or a vendor partner under MSA with Higginbotham. 

Please do not contact or send unsolicited potential placements to our team members.

*Applications will be accepted until the position is filled