Note: The job is a remote job and is open to candidates in USA. EPITEC is a leading healthcare insurance company seeking a Sales Solutions & Compliance Analyst to support agent and agency compliance programs. The role involves managing compliance cases, analyzing findings, and collaborating with stakeholders to ensure compliance requirements are met.
Responsibilities
- Manage, process, and document Sales Development Action Program (SDAP) cases from initiation through resolution
- Research potential application and enrollment issues related to agent activity and determine whether compliance violations have occurred
- Gather, analyze, and document findings for committee review and final determination
- Review agent history and assess potential risk when evaluating reinstatement and re-contracting requests
- Investigate complaints, appeals, and compliance concerns submitted by agents, agencies, or internal business partners
- Make recommendations regarding corrective actions, training, counseling, and remediation requirements
- Ensure all case activities are completed, documented, and followed through to resolution
- Communicate with agents, agencies, and internal stakeholders regarding case status, requirements, and outcomes
- Serve as a liaison between compliance committees, Sales Account Management teams, and internal/external partners
- Facilitate meetings and discussions with agents and agencies to address concerns and identify opportunities to prevent future issues
- Conduct training and coaching sessions for agents and sales representatives as needed
- Perform quality reviews and audits to ensure compliance with CMS, federal, state, and company regulations
- Support program development, process improvements, and regulatory compliance initiatives
- Maintain accurate documentation, reports, communication updates, and departmental records
- Act as a technical resource and mentor to team members while supporting cross-training efforts
Skills
- Experience in compliance, investigations, auditing, quality assurance, risk management, insurance operations, or related fields
- Strong analytical and critical-thinking skills
- Ability to independently research issues, evaluate findings, and make recommendations
- Excellent written and verbal communication skills
- Strong organizational and documentation abilities
- Comfortable working with internal and external business partners
- Ability to manage multiple priorities in a fast-paced environment
- Proficiency with Microsoft Office applications, including Excel
- Health Insurance or Medicare Operations
- Compliance & Regulatory Programs
- Agent/Broker Oversight
- Appeals & Grievances
- Risk Assessment
- Sales Operations
- Quality Assurance
- Case Management
- Agent Licensing or Credentialing
Benefits
- Equipment Provided
Company Overview