Compliance Specialist

6 days ago


Atlanta, Georgia, United States Focus People Full time
Job Overview

Focusing on compliance-driven healthcare access, Focus People seeks a detail-oriented professional to support Quality Health Plans and Stand-Alone Dental Plans in Georgia. This role involves policy implementation, monitoring, and effective communication with health insurance carriers.

Responsibilities
  • Policymaking: Develop policies for QHP/SADP applications, timelines, and data corrections to ensure adherence to state and federal standards.
  • Regulatory Updates: Review annual regulatory updates (CCIIO guidelines, Payment Parameters) and revise processes as needed to maintain compliance.
  • Compliance Reviews: Conduct thorough reviews of QHP applications to guarantee adherence to state and federal requirements.
  • Re-enrollment and Carrier Communications: Manage annual auto re-enrollment and health carrier communications to prevent non-compliance issues.
  • Accuracy Monitoring: Continuously monitor health insurance carrier information for accuracy in the Eligibility and Enrollment System.
  • Corrective Action Planning: Develop corrective action plans for non-compliance incidents and support carrier relations through issue tracking and engagement.
  • User Representation: Represent issuer interests during system requirement sessions and User Acceptance Testing (UAT).
  • Employer Application Processing: Process employer applications for SHOP eligibility and maintain detailed records per federal and state guidelines.
Requirements
  • A minimum of four years of job-related experience or two years in a related compliance role.
  • Familiarity with ACA, federal/state health insurance policies, and HIPAA regulations.
  • Experience with ACA insurance plan credentialing and certification.
  • Strong program management, data analytics, and reporting skills.
  • Knowledge of health technology systems.
Salary
The estimated annual salary for this position is approximately $60,000-$80,000 depending on experience and qualifications.About Us
Focus People strives to provide meaningful opportunities for professionals to make an impact in the healthcare industry.

  • Atlanta, Georgia, United States Larson Maddox Full time

    Job OverviewWe are currently working with Larson Maddox, a leading insurance firm seeking a Regulatory Compliance Specialist to support its regulatory compliance programs. This role involves handling regulatory filings, managing compliance training, and conducting regulatory research while serving as a compliance resource across various departments.


  • Atlanta, Georgia, United States destinationone Consulting Full time

    Job SummaryAt destinationone Consulting, we are committed to excellence in recruitment across various sectors. As an Audit Compliance Specialist, you will play a vital role in ensuring the accuracy and integrity of our clients' financial reporting processes.Estimated Salary: $60,000 - $80,000 per annumAbout the RoleWe are seeking an experienced professional...


  • Atlanta, Georgia, United States Home Depot Management Company, LLC Full time

    About This OpportunityWe are seeking a seasoned Legal Compliance Specialist to join our team at Home Depot Management Company, LLC. This role offers a competitive salary of $120,000 - $160,000 per annum, commensurate with experience.


  • Atlanta, Georgia, United States Airgas Full time

    Job DescriptionAs a Safety Compliance Specialist at Airgas, you will play a key role in ensuring the company's operations are in compliance with all relevant regulations and laws.Key ResponsibilitiesEnsure compliance with OSHA, EPA, DOT, DHS, and FDA regulations, as well as state requirements.Take ownership of improving safety and compliance at each location...


  • Atlanta, Georgia, United States Airgas Full time

    Job OverviewWe are seeking a highly skilled Safety Compliance Specialist to join our team at Airgas. This role is responsible for ensuring compliance with federal, state, and local regulations related to safety and compliance.


  • Atlanta, Georgia, United States Home Depot Full time

    Job Overview">The Home Depot is seeking a skilled Compliance Risk Assessment Specialist to join its Compliance Program Effectiveness team. This role involves executing project-based compliance risk assessments, analytics, and ongoing monitoring to support internal consulting efforts.


  • Atlanta, Georgia, United States Atlanta Postal Credit Union Full time

    Role OverviewThe Atlanta Postal Credit Union seeks a skilled Compliance Governance Specialist to ensure the institution's regulatory compliance and risk management. This role is pivotal in maintaining the credit union's integrity and reputation.Key Responsibilities:Regulatory Compliance: Ensure all forms, documents, and disclosures align with applicable laws...


  • Atlanta, Georgia, United States Emory HealthcareEmory University Full time

    OverviewWe are seeking a skilled Compliance Specialist to join our team at Emory Healthcare. As a Compliance Specialist, you will play a critical role in ensuring the accuracy and compliance of our inpatient hospital coding practices.In this position, you will develop and execute audits, monitoring, and education for inpatient hospital billing, coding, and...


  • Atlanta, Georgia, United States Emory HealthcareEmory University Full time

    At Emory Healthcare, we are dedicated to delivering exceptional patient care and advancing medical research. As a Compliance Specialist for Inpatient Coding and Billing, you will play a crucial role in ensuring the accuracy and integrity of our coding and billing processes.About the RoleThis is an exciting opportunity to join our team and contribute to our...


  • Atlanta, Georgia, United States City of Atlanta Full time

    Job SummaryWe are seeking a highly detail-oriented Regulatory Compliance Specialist to join our team at the City of Atlanta. The successful candidate will be responsible for ensuring that all regulatory guidelines are followed and regulations are met.Key ResponsibilitiesReview and verify records, reports, software, and other relevant programs to ensure...


  • Atlanta, Georgia, United States Starr Insurance Companies Full time

    Starr Insurance Companies OverviewWe are a leading insurance and investment organization, providing commercial property and casualty insurance to businesses worldwide.Job DescriptionWe are seeking a Data Protection Compliance Specialist to support our Associate General Counsel and Global Compliance Director in administering our Data Loss Protection program....


  • Atlanta, Georgia, United States Kemira Full time

    Secure a Rewarding Career in Product ComplianceKemira, a leading provider of sustainable chemistry solutions for water-intensive industries, is seeking a skilled Product Compliance Specialist to join its dynamic team.The successful candidate will be responsible for ensuring compliance with all relevant regulations and standards for Kemira's products. This...


  • Atlanta, Georgia, United States CorDx Full time

    Job OverviewCorDx, a leading biotechnology company, is seeking an experienced Regulatory Compliance Specialist to ensure seamless regulatory operations. This role involves coordinating with cross-functional teams to guarantee compliance with industry regulations and guidelines.About the RoleThe ideal candidate will possess excellent organizational and...


  • Atlanta, Georgia, United States GeorgiaGov Full time

    Hiring For Georgia RegionThe Construction Compliance Specialist monitors the day-to-day progress of construction projects for the Georgia State Government. This includes reviewing work to ensure compliance with plans/specifications, observing stored materials, documenting work in place and job site conditions, as well as on-site workforce. The specialist...


  • Atlanta, Georgia, United States Wolters Kluwer DXG U.S., Inc. Full time

    About the RoleWolters Kluwer DXG U.S., Inc. is seeking a skilled Information Security Risk and Compliance Specialist to join our team. This is an exciting opportunity for a motivated individual to work in a dynamic environment and contribute to the success of our organization.


  • Atlanta, Georgia, United States Pivotal Med Supply Full time

    Pivotal Med Supply is a leading provider of innovative medical supplies and solutions. We are dedicated to maintaining the highest standards of compliance and accuracy in all our processes.Our company overview showcases our commitment to excellence, ensuring that we deliver top-notch medical solutions to our clients.Salary: $55,000 - $65,000 per annumJob...


  • Atlanta, Georgia, United States DeKalb County School District Full time

    Job OverviewThe DeKalb County School District is seeking a highly motivated and experienced Financial Specialist II to join our team. This role will be responsible for obtaining Federal and State funds for the DeKalb County Nutrition Program, monitoring daily cash deposits from school cafeterias, and preparing financial reports to meet state and federal...


  • Atlanta, Georgia, United States GeorgiaGov Full time

    Job Title:Financial Compliance Analyst - Insurance SpecialistCompany Overview:GeorgiaGov is a government institution dedicated to ensuring the integrity of the insurance industry in our state. As a Financial Compliance Analyst, you will play a critical role in maintaining the trust and confidence of our citizens.Estimated Salary:$62,000 - $85,000 per yearJob...


  • Atlanta, Georgia, United States Cantaloupe,Inc. Full time

    Financial Audit Internship Summer '25Cantaloupe, Inc. is seeking a highly motivated and detail-oriented Compliance and Risk Management Specialist to join its Internal Audit department as an intern.The selected candidate will drive critical projects to enhance internal audit software, assist with IIA Standard alignment initiatives, and develop management...


  • Atlanta, Georgia, United States PRGX Global, Inc. Full time

    About This OpportunityAre you a detail-oriented professional with a passion for auditing and compliance? Do you have experience in reviewing contracts and ensuring regulatory compliance? If so, we may have the perfect opportunity for you! PRGX Global, Inc. is seeking an experienced Audit Compliance Specialist to join our team in Atlanta, GA.Key...