Regulatory Compliance Analyst

3 weeks ago


Baltimore, United States Lumen Solutions Group Inc. Full time

Company Description

Lumen Solutions Group Inc. is a technology consulting Services Company based in Virginia. We provide a wide array of experienced business and IT professionals supporting clients from solution design to implementation and support. We specialize in strategy development, portfolio management and enterprise architecture.



All potential candidates should read through the following details of this job with care before making an application.

Job Title: Regulatory Compliance Analyst

Location: Baltimore, Maryland-hybrid

Duration: Long term Contract

Job Description:

The role of the Special Investigations Unit (SIU) Investigator is to assist in the reduction and recuperation of losses through the detection, investigation, and resolution of low to medium levels fraud, waste, and abuse schemes, resulting in the savings and recovery of funds.

Independently conduct low to medium level investigations and provide support as part of an assigned team to all levels (low to medium) investigations of suspected fraud, waste, and abuse. In conjunction with assigned team or management, develop and execute investigative plans that may include performance of audits of financial business records, provider and subscriber medical data, claims, systems’ reports, medical records, analysis of contract documents, provider/subscriber claims history, benefits, external data banks and other documents to determine the possible existence of fraud and/or abuse.

Preferred Qualifications

Credential in a health care or investigations related area such as Certified Fraud Examiner (CFE), Accredited Health Fraud Investigator (AHFI), RN/LPN, or Certified Professional Coder (CPC).

Knowledge of ICD 10 and CPT® Codes, medical terminology, extensive training in claims and subscriber customer service methods, and previous experience in the health care industry.

Knowledge, Skills and Abilities (KSAs):

Proficiency Knowledge of laws that pertain to public and insurance funds - Proficient Excellent communication skills both written and verbal. - Proficient Ability to recognize, analyze, and solve a variety of problems. - Proficient Ability to maintain effective interpersonal relationships.

Additional information

Interview format: 1st – Phone Screen, 2nd – MS Teams Video Interview

Please send resume to:

jobs@lumensolutions.com



  • Baltimore, United States UMMS Community Impact Grant Program Full time

    Hybrid model consists of 3 days a week in-office, and 2 days from home. Mondays are mandatory in-office at our Linthicum location. First weeks of training are fully on-site. Being among the top 25 employers in the state and recently recognized as America’sBest Large Employer 2021 by Forbes, UMMS brings together a diverse andcollaborative team of innovators...


  • Baltimore, United States Stifel Full time

    SummaryThe Compliance Analyst supports the Firm's Equity Sales and Trading Compliance Department, focusing on equity market making, options, and electronic trading desks.Essential Duties & ResponsibilitiesAssist in maintaining an effective trading compliance program through monitoring and surveillance of sales and trading activities (reviews consist of best...


  • Baltimore, United States Fidelity National Information Services Inc Full time

    Position Type : Full time Type Of Hire : Experienced (relevant combo of work and education) Education Desired : Bachelor of Business Administration Travel Percentage : 0% Are you ready to unleash your full potential? We're looking for people who are passionate about payments to chart Worldpay's path to being the largest and most-loved payments company in the...

  • Internal Audit

    4 days ago


    Baltimore, United States binance Full time

    Binance is the leading global blockchain ecosystem and cryptocurrency infrastructure provider whose suite of financial products includes the world’s largest digital-asset exchange. Our mission is to accelerate cryptocurrency adoption and increase the freedom of money. If you’re looking for a fast-paced, mission-driven organization where opportunities to...


  • Baltimore, United States Stifel Full time

    Summary The Municipal Compliance Analyst I is a key member of the Municipal Compliance team responsible for compliance analysis and reporting requirements, including conducting conflict check requests and reviewing and approving political contribution requests and bond ballot contributions for the Firm. Essential Duties & Responsibilities * Supports the...

  • Systems Analyst

    4 weeks ago


    Baltimore, United States Bridgeway Benefit Technologies Full time

    Job DescriptionJob DescriptionWe are looking for a skilled Systems Analyst to join our growing Customer Success organization at Bridgeway Benefit Technologies. As a Systems Analyst working on our Regulatory & Specialized Programs team, you will work closely with all divisions within Bridgeway, as well as our customers and trading partners to architect,...


  • Baltimore, United States JobRialto Full time

    Description Department Profile Professionals within Legal and Compliance provide a wide range of services to our business units. They might help to structure a complex and sensitive cross-border transaction; advise on a new product introduction; develop a training program or defuse an investor dispute. They preserve the Firm's invaluable reputation for...

  • Manager, QA

    7 days ago


    Baltimore, United States Knewin Full time

    Company Description At Alertus, protecting people from harm is our mission and our passion. As the leader in mass notification, we are committed to providing customizable, scalable, and cost-effective solutions, as we know even a few seconds of warning can help save lives during an emergency. Our employees are integral to the company’s success and impact...


  • Baltimore, United States Maryland Department of Transportation Full time

    **Interview & Hire Announcement** **State Highway Administration** **Office of Environmental Design - Baltimore City Grade 14 (8433) SP#24-61.5-03** **Environmental Analyst I** **YOU MUST APPLY ONLINE TO BE CONSIDERED FOR THIS POSITION** *** **THE RECONSIDERATION PERIOD FOR THIS RECRUITMENT IS THREE (3) BUSINESS DAYS** **Recruitment**: The State...


  • Baltimore, United States Shimano American Corp. Full time

    Product Compliance Specialist page is loaded Product Compliance Specialist Apply locations Eindhoven, The Netherlands time type Full time posted on Posted 2 Days Ago job requisition id R1245 Introduction At Shimano high quality is key and part of this drive is product compliance, adhering to technical standards and sustainability. The challenge of the...


  • Baltimore, United States Phyton Talent Advisors Full time

    Our client, a Global Investment Bank, is seeking a Compliance specialist in their Baltimore, MD location:Responsibilities:Develop, maintain or enhance securities licensing processes and proceduresRespond to regulatory and registration requestsSupport process workflows and the systems utilized to associate registered individual'sHandle resolution of escalated...


  • Baltimore, United States ANGARAI Full time

    Job Description Job Description Job Title: Environmental Compliance Manager - Construction Job Location: Baltimore, MD, USA Last day to apply: 30-Oct-2023 ANGARAI - Project Management firm based out of College Park, MD. ANGARAI is a professional management firm that is driven by excellence. We provide ample opportunities for growth in a challenging, yet...


  • Baltimore, United States Phyton Talent Advisors Full time

    Our client, a Global Investment Bank, is seeking a Compliance specialist in their Baltimore, MD location: Responsibilities: Develop, maintain or enhance securities licensing processes and procedures Respond to regulatory and registration requests Support process workflows and the systems utilized to associate registered individual's Handle resolution of...


  • Baltimore, United States Angarai Intl Full time

    Job Title: Environmental Compliance Manager - Construction Job Location: Baltimore, MD, USA Last day to apply: 01-Sep-2023 ANGARAI - Project Management firm based out of College Park, MD. ANGARAI is a professional management firm that is driven by excellence. We provide ample opportunities for growth in a challenging, yet closely-knit atmosphere. Our key...


  • Baltimore, United States ANGARAI Full time

    Job DescriptionJob DescriptionJob Title: Environmental Compliance Manager - ConstructionJob Location: Baltimore, MD, USALast day to apply: 30-Oct-2023ANGARAI - Project Management firm based out of College Park, MD.ANGARAI is a professional management firm that is driven by excellence. We provide ample opportunities for growth in a challenging, yet...


  • Baltimore, United States TITAN Consulting, LLC Full time

    Title: Sr. Manager Environmental Regulatory Policy Location: VA, MD, or DC area Skills: Regulatory policies Type: Direct Hire Pay Rate: TBD based on experience – $150-200K Duration: Long Term Start Date: ASAP Sr. Manager Environmental Regulatory Policy Minimum Qualifications: Bachelor’s Degree in a related area of study. (no specific degree required,...


  • Baltimore, United States Eteam Infoservices Ltd. Full time

    * DURATION 3 MONTHS *** Hybrid: 3 days on site per week"Since these individuals will be making regulatory filings, we need candidates that can demonstrate aptitude, strong communication and organizational skills, and will embrace the opportunity to learn, while working on a firm-wide initiative. We've had several contingents in the past that came from the...


  • Baltimore, United States eTeam Infoservices Ltd. Full time

    DURATION 3 MONTHS Hybrid: 3 days on site per week 'Since these individuals will be making regulatory filings, we need candidates that can demonstrate aptitude, strong communication and organizational skills, and will embrace the opportunity to learn, while working on a firm-wide initiative. We've had several contingents in the past that came from the legal...


  • Baltimore, United States eTeam Infoservices Ltd. Full time

    * DURATION 3 MONTHS *** Hybrid: 3 days on site per week "Since these individuals will be making regulatory filings, we need candidates that can demonstrate aptitude, strong communication and organizational skills, and will embrace the opportunity to learn, while working on a firm-wide initiative. We’ve had several contingents in the past that came...


  • Baltimore, United States Expert Executive Recruiters Full time

    Compliance Officer - North America Our client is a leading global end-to-end retail technology platform for unattended & attended commerce. Their mission is to simplify commerce and payments for retailers while driving growth, optimizing operations, and enhancing consumer engagement. With a strong global presence over the past 17 years, their core products...