[Remote] Regulatory Compliance Analyst (Remote) - Privacy

Note: The job is a remote job and is open to candidates in USA. CareFirst BlueCross BlueShield is seeking a Regulatory Compliance Analyst who will conduct independent analysis for complicated regulatory inquiries and provide interpretation of regulatory rules and guidelines. The role involves ensuring compliance with state and federal requirements, maintaining relationships with regulators, and preparing documentation for legal actions.

Responsibilities

• Provide interpretation of regulations and regulatory rules/guidelines to ensure compliance with state and federal requirements. Review and analyze all data received to generate comprehensive written responses to the originating party. Strategize with Legal and Compliance as needed to identify the best response to the complaint. Maintain positive, responsive, respectful relationships with all regulators. Occasional external contact with Regulatory Agency Investigators
• Identifies potential volatile activity by gathering and analyzing regulated organizational data. Research, resolve and respond to written and telephone inquiries received. Coordinate with internal and external parties to ensure accurate information is obtained. Review and analyze provided data and information. Provide detailed professionally written responses to originating party, ensuring all questions are answered and customer needs are effectively served within designated time frames while ensuring privacy needs of members are respected. Maintain database of cases
• Review, analyze, prepare detailed documentation for support of legal action pertaining to the organization indemnity business, ensuring that all appropriate materials, related claims, contracts, payment vouchers are included. Prepares investigative information and reports by collecting, analyzing, and summarizing data and trends; presents recommendations
• Improves regulatory investigation job knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; benchmarking state-of-the-art practices; participating in professional societies
• Contributes to regulatory investigation and company success by welcoming related, different, and new requests; helping others accomplish job results

Skills

• Bachelor's Degree OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience
• 1 year experience in a regulatory, compliance or customer service role
• Skill in using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to problems
• Ability to convey information in a clear, concise, and logical manner
• Ability to effectively convey information to others
• Excellent critical thinking and communication skills both written and verbal
• Consistently maintains highly professional written and verbal interaction with all levels of staff within the company and with members of regulatory agencies
• Must be eligible to work in the U.S. without Sponsorship
• Demonstrated experience to on claims and service systems, business rules by product and platform

Benefits

• CareFirst offers a comprehensive benefits package
• Various incentive programs/plans
• 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements)

Company Overview