Conducted compliance reviews and audits in alignment with CMS and federal regulations for Qualified Health Plan (QHP) Issuers.
Researched and analyzed regulatory updates to ensure testing and procedures remained current and accurate.
Documented findings and prepared detailed reports and exhibit for federal and internal stakeholders.
Modified audit software and documentation to reflect finaliz...
Harrisburg, Pennsylvania, United StatesAs a Compliance Analyst at Capital Blue Cross, I manage searches of prospective employees and providers against state and federal preclusion and exclusion lists, streamline processes by developing efficient workflows, and collaborate with management to ensure compliance deadlines are met. Additionally, I present reports on healthcare compliance topics, implement and review departmental polici...