Compliance Specialist at Kforce Inc in San Antonio, Texas

Job Description:

RESPONSIBILITIES:

Kforce has a client that is seeking a Compliance Specialist in San Antonio, TX.

Overview:
The Compliance & Regulatory Specialist oversees and ensures compliance across operational areas within the health plan, including delegated activities and regulatory reporting. This role requires familiarity with current Texas Medicaid regulations, Texas Department of Health and Human Services guidelines, Texas Department of Insurance (TDI) regulations, Office of Inspector General (OIG) Compliance Plan, and Centers for Medicare and Medicaid Services (CMS) requirements. Additionally, the Specialist must be knowledgeable about health plan documents such as Summaries of Benefits and Coverage, Schedules of Benefits, and Certificates of Coverage.

Responsibilities include coordinating regulatory obligations, interpreting regulatory changes, and implementing compliance measures, including HIPAA guidelines. The Compliance Specialist will be building strong relationships with regulatory agencies and internal stakeholders is essential to enhance interaction, transparency, and accountability.

REQUIREMENTS:

• Bachelor's degree in Business Administration, Public Administration, Health Care Administration, or a related field is preferred, although relevant experience can substitute for formal education


• Proficiency in Microsoft Office applications is required

The pay range is the lowest to highest compensation we reasonably in good faith believe we would pay at posting for this role. We may ultimately pay more or less than this range. Employee pay is based on factors like relevant education, qualifications, certifications, experience, skills, seniority, location, performance, union contract and business needs. This range may be modified in the future.

We offer comprehensive benefits including medical/dental/vision insurance, HSA, FSA, 401(k), and life, disability & ADD insurance to eligible employees. Salaried personnel receive paid time off. Hourly employees are not eligible for paid time off unless required by law. Hourly employees on a Service Contract Act project are eligible for paid sick leave.

Note: Pay is not considered compensation until it is earned, vested and determinable. The amount and availability of any compensation remains in Kforce's sole discretion unless
and until paid and may be modified in its discretion consistent with the law.

This job is not eligible for bonuses, incentives or commissions.

Kforce is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.

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