Compliance Supervisor (186469-5)

Oct 27 2017
ALTRES Office |Honolulu|Full Time, $50,000 / year
Job Description

Highly analytical individual is needed for fill a Compliance Supervisor position with a health care management company. This role is in charge of investigating regulatory issues, managing subrogation, and supervising investigations of member eligibility in addition to a variety of tasks. 

 

Due to the nature of this position, previous experience with legal writing, handling appeals, and overseeing investigations is preferred but we will consider any applicant who meets the listed requirements. 

 

Ad​ditional Responsibilities:

 

Appeals

 

  • Research and investigate formal appeals
  • Gather recommendations and information and present them to senior management and clients
  • Handle complaints and requests for external review or arbitration
  • Research, investigate, and log complaints
  • Draft response letters to appellants

Subrogation and TPL

 

  • Contact legal representatives for TPL cases
  • Obtain status of subrogation cases
  • Prepare lien recap reports
  • Maintain a log of actions and status or review 
  • Analyze medical medical and financial data
  • Enter information into databases

 

 

 

 

Research and Investigation

 

  • Oversee and conduct investigations
  • Ensure cases are initiated within specified time frames
  • Review and update logs and diaries 
  • Update enrollment records in the eligibility system to indicate liability
  • Compose and flag correspondence to external customers
Miscellaneous:
  • Conduct department meetings
  • Maintain and update department manuals and documents
  • Ensure department is cross-trained on responsibilities

 

 

Required Education and Qualifications:

 

  • High school diploma or equivalent
  • Minimum three years of supervisory experience
  • Proficiency with Microsoft Word, Excel, and Outlook
  • Strong analytical and time management skills
  • Ability to effectively lead a team
Preferred Qualifications:
  • College degree
  • Legal writing skills
  • Previous experience handling appeals, investigations, and/or subrogation