Compliance Specialist

JOB SUMMARY

The Compliance Specialist safeguards the company the company’s operational integrity and market presence by leading the acquisition, maintenance, and renewal of essential state licenses and regulatory registrations across all business units. By proactively monitoring evolving state legislation, regulations, and industry standards, this role ensures full organizational adherence to complex medical review laws, including URO and IRO mandates. Additionally, the specialist acts as a trusted liaison for external state agencies and client compliance audits, delivering timely, precise responses that build customer trust and uphold company standards. Ultimately, this position mitigates compliance risks and empowers seamless operational execution across all regions the company the company serves.

Mission, Culture & Values

At the company the company, we believe exceptional employee experiences create exceptional client experiences. Our culture is built on collaboration, continuous improvement, accountability, and care.

We care for our customers, we care for our employees, and we care for one another. Every team member plays an important role in creating an environment where people feel respected, supported, empowered to grow, and inspired to do meaningful work.

What You’ll Do

Licensure & Regulatory Strategy

• Lead end-to-end application, acquisition, and renewal processes for state licenses and registrations, including Utilization Review Organization (URO) and Independent Review Organization (IRO) filings.

• Identify, monitor, and research state-specific laws, administrative rules, and emerging legislation impacting the company the company’s lines of business to keep operations proactively compliant.

Customer & External Compliance Operations

• Respond to internal and external customer compliance requests and regulatory audits by preparing and delivering high-quality, precise written deliverables.

• Act as a direct liaison with state licensing agencies, regulatory bodies, and external compliance auditors to facilitate smooth interactions and maintain positive working relationships.

Corporate & Financial Compliance Support

• Manage diversity spend compliance requirements, collaborating closely with the Finance team to gather, analyze, and present accurate reporting data.

• Coordinate with the company the company’s registered agent to submit accurate state Secretary of State annual reports on a timely basis across all operating jurisdictions.

Administrative & Cross-Functional Operations

• Maintain centralized compliance documentation, tracking systems, and renewal calendars to prevent lapse in state authorizations.

• Provide additional administrative and research assistance to leadership on special regulatory or legal projects as needed.

Other duties

What Makes This Role Successful

Success in this role means taking proactive ownership of regulatory obligations so that the company the company never encounters a disruption in licensing or service delivery. High performers excel by combining sharp legal research skills with strict attention to detail, consistently anticipating audit needs and renewal timelines ahead of deadlines. A successful Compliance Specialist approaches regulatory requirements with a solution-oriented mindset, simplifying complex state nuances into clear actionable steps for internal teams while delivering dependable, polish-oriented service to external partners and regulators.

What Your First 90 Days May Look Like

• First 30 days: Complete onboarding to understand the company the company’s lines of business, internal systems, and current state licensing footprint. Shadow current compliance processes, review active URO/IRO licensing documentation, and build familiarity with registered agent tools and tracking workflows.

• First 31–60 days: Take direct ownership of upcoming state license renewals and Secretary of State annual filings. Independently field routine internal/external compliance inquiries, begin collaborating with Finance on diversity spend metrics, and establish a rhythm for tracking state legislative updates.

• First 61–90 days: Lead complex licensing applications and state audit response deliverables with minimal oversight. Evaluate existing compliance workflows to recommend process improvements, showing full mastery over regulatory research and cross-departmental coordination.

Requirements

EDUCATION/CREDENTIALS

• Bachelor’s Degree (BS/BA) or formal Paralegal Certification.

Must Haves

• Demonstrated experience in Regulatory Compliance, state filings, or a paralegal role.

• Strong legal research, investigative, and analytical problem-solving abilities.

• Proficiency in MS Office systems and compliance documentation tools.

• Proven track record of working independently, managing tight deadlines, and maintaining exceptional organization.

• Strong written and verbal communication skills across all organizational levels and external stakeholders.

Preferred Qualifications

• Prior background working in the medical review, insurance, or general liability claims industry.

• Direct experience with Utilization Review Organization (URO) or Independent Review Organization (IRO) state registrations.

WORKING CONDITIONS/PHYSICAL DEMANDS

Any lifting, bending, traveling, etc. required to do the job duties listed above. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this role. Examples:

• Prolonged periods sitting or remaining stationary at a desk and working on a computer.

• Constant operation of a computer, keyboard, mouse, and other digital productivity tools.

• Close visual acuity required to view computer screens, analyze data, and read extensive digital documentation.

• Frequent communication with team members, leadership, and external partners via email, chat, phone, and video conferencing platforms.

• Occasional moving or positioning of office equipment or files weighing up to 10–15 pounds.

Why Join the company the company?

• Collaborative remote culture

• Professional growth opportunities

• Meaningful work supporting the healthcare industry

• Comprehensive benefits

• Great Place to Work Certified since 2021

• Commitment to employee development

WORK FROM HOME TECHNICAL REQUIREMENTS

• Supply and support their own internet services.

• Maintaining an uninterrupted internet connection is a requirement of all work from home position.

Equal Opportunity Statement

At the company the company, caring for people is at the heart of what we do. We are committed to creating an inclusive workplace where every employee feels respected, valued, and empowered to contribute. We provide equal employment opportunities to all applicants and employees and make employment decisions based on qualifications, merit, business needs, and without regard to race, color, religion, sexual orientation, gender identity or expression, national origin, age, disability, veteran status, or any other characteristic protected by applicable federal, state, or local law.

This job description is subject to change at any time.

Benefits

Join our team at the company the company and enjoy a comprehensive benefits package designed to support your well-being and peace of mind. We offer a range of benefits including medical, dental, and vision coverage for you and your family. Additionally, we offer voluntary life insurance options for you, your spouse, and your children. We also offer other voluntary benefits which include hospital indemnity, critical illness, accident indemnity, and pet insurance plans. Employees receive basic life insurance, short-term disability, and long-term disability coverage at no cost. Our generous paid time off policy ensures you have time to relax and recharge, while our 401k plan with a company match helps you plan for your future. Apple equipment and a media stipend are provided for remote workspace.

ABOUT the company the company

A fast-paced, Inc. 500 Company with a high-performance culture, is seeking insightful forward-thinking professionals. We process over 200,000 insurance claims annually for leading national and regional Workers’ Compensation, Disability, Auto, and Group Health Carriers, Third-Party Administrators, Managed Care Organizations, Employers, and Pharmacy Benefit Managers. We provide customized Independent Medical Exams and Peer Review programs that assist our clients in reaching the appropriate medical determination as part of the claims management process.