Medicare Compliance Specialist

2 weeks ago

West Jordan, UT, United States Integrity Marketing Group Full time
Position Summary
The Medicare Compliance Specialist is responsible for supporting the organization's compliance program with a focus on Medicare regulations. This role will ensure adherence to federal and carrier-specific requirements, oversee audit activities, and maintain regulatory compliance processes that safeguard compliant operations. The ideal candidate will have prior experience in Medicare compliance, strong analytical skills, and the ability to interpret and apply complex regulatory requirements to day-to-day business operations.

Key Roles & Responsibilities
  • Carrier Audit Management
    • Coordinate, prepare, and respond to carrier audit requests.
    • Gather, review, and submit necessary documentation to meet audit requirements.
    • Track audit outcomes, corrective actions, and report findings to leadership.
  • Regulatory Oversight & Database Management
    • Maintain a comprehensive database of federal and state Medicare regulations.
    • Monitor updates to CMS guidelines, carrier notices, and other regulatory requirements.
    • Communicate regulatory changes and compliance updates to internal stakeholders.
  • Compliance Monitoring & Selling Processes
    • Ensure compliant Medicare selling processes are followed in alignment with CMS and carrier standards.
    • Review and audit sales and marketing materials for compliance accuracy.
    • Provide guidance and training to sales staff regarding compliant practices.
  • Carrier Compliance Coordination
    • Serve as a liaison with Medicare Advantage and Prescription Drug Plan carriers regarding compliance expectations.
    • Monitor carrier communications and policy updates to ensure company alignment.
    • Support implementation of carrier-mandated compliance programs and procedures.
  • Compliance Risk Management & Reporting
    • Conduct internal reviews to assess compliance with Medicare program requirements.
    • Identify risks and recommend corrective action plans to address potential gaps.
    • Assist in preparing compliance reports for leadership and regulatory bodies.
  • General Responsibilities
    • Support ongoing compliance program initiatives and audits.
    • Participate in compliance training development and delivery.
    • Perform other compliance-related duties and special projects as assigned.
Qualifications
  • Minimum 2-4 years of experience in Medicare compliance, auditing, or regulatory oversight.
  • Strong knowledge of CMS regulations, Medicare Advantage, and Part D programs.
  • Experience with carrier compliance requirements and audit coordination.
  • Excellent organizational, communication, and analytical skills.
  • Ability to manage multiple projects, meet deadlines, and adapt to regulatory changes.


About Integrity

Integrity is one of the nation's leading independent distributors of life, health and wealth insurance products. With a strong insurtech focus, we embrace a broad and innovative approach to serving agents and clients alike. Integrity is driven by a singular purpose: to help people protect their life, health and wealth so they can prepare for the good days ahead.

Integrity offers you the opportunity to start a career in a family-like environment that is rewarding and cutting edge. Why? Because we put our people first At Integrity, you can start a new career path at company you'll love, and we'll love you back. We're proud of the work we do and the culture we've built, where we celebrate your hard work and support you daily. Joining us means being part of a hyper-growth company with tons of professional opportunities for you to accelerate your career. Integrity offers our people a competitive compensation package, including benefits that make work more fun and give you and your family peace of mind.

Headquartered in Dallas, Texas, Integrity is committed to meeting Americans wherever they are - in person, over the phone or online. Integrity's employees support hundreds of thousands of independent agents who serve the needs of millions of clients nationwide. For more information, visit Integrity.com.

Integrity, LLC is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, national origin, disability, veteran status, or any other characteristic protected by federal, state, or local law. In addition, Integrity, LLC will provide reasonable accommodations for qualified individuals with disabilities.

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