Compliance and Special Investigations (SIU) Coordinator

All about us

You likely know us as an insurance company, but that's just a portion of what we do. Hundreds of thousands of North Dakotans trust us to provide them with personalized service and unmatched access to care. It's a mission we take seriously.

We also work with entities throughout the state to challenge the cost and complexity of health care in North Dakota. This uncompromising goal requires caring, innovative people who are ready and willing to help create a new level of health and well-being in North Dakota and beyond.

Work environment

This opportunity is open to a remote, hybrid or in-office working arrangement out of the Fargo, ND office. We empower our employees to find a work style that is best for them. Learn more at Life at Blue | BCBSND.

Pay information

• Pay Level: 019
• FLSA Category: Nonexempt - Hourly
• Individual pay will be based on skills, experience, qualifications, location, internal equity, and other relevant factors.
• Opportunities for continued salary growth through a performance-based merit program.

A day in the life

The Compliance and Special Investigations (SIU) Coordinator is responsible for performing operational support activities within the division such as coordination and support of audits and examinations, assisting with compliance and investigations, conducting research, reviewing reports, and preparing correspondence. This position provides ongoing support to all areas within the division and provides various levels of support in alignment with business needs and strategic goals.

Your responsibilities will include

• Assists internal and external stakeholders during audit processes through the preparation and distribution of requested information.
• Provides support to the team by assisting with investigations, resolving reports that violate a company policy, procedure, practice or contractual agreement within the organization and coordination and tracking of regulations.
• Utilizes reports and databases to monitor department-related activities.
• Maintains accurate records, documentation, and evidence as it relates to basic fraud, waste, and abuse cases. Submits claims for adjustments in accordance with established processes and policies.
• Organizes and composes a variety of communication materials such as presentations, contracts, letters, assessments, etc. Reviews and proofreads a variety of documents and creates reports, charts, and other materials.
• Coordinates training sessions and curriculum with internal resources/subject matter experts who play an integral role in the facilitation of information.
• Performs research, collects data, and prepares information for special projects and initiatives within the division, as needed.
• Assists with maintaining workload within the division, when requested.

What you need to succeed

• A Bachelor's degree in Business, Healthcare, Legal, Auditing, Criminal Justice, or related field.
• 3 years of project management, data analysis, audit, investigations, law, compliance, or related experience.
• Be a problem solver with the ability to research, analyze and define methods, practices, and procedures to resolve issues.
• Ability to communicate verbally or in writing with individuals and groups to deliver or exchange information.
• Desire to expand knowledge base as benefit practices continue to evolve in the workplace.
• Clearly communicate and support employees in a variety of situations, while also being flexible and adaptable.
• Demonstrated a combination of listening, communication, problem solving and facilitation skills.
• A strong ability to prioritize and organize work with varying timelines for projects and daily work.

Equivalent combination of education, experience or training determined to be acceptable by Human Resources may be substituted, unless regulated by contract or program standards

Benefits

• Affordable medical, dental and vision coverage accepted throughout the United States
• Employer funded Lifestyle Spending Accounts, Health Savings Accounts and Health Reimbursement Arrangements
• Employer-paid life and disability insurance
• 401(k) retirement plan with company match and immediate vesting
• Paid holidays, paid time off (PTO), PTO donation program, and paid parental leave
• Voluntary benefits including Accident, Hospital Indemnity, Critical Illness, Term/Whole Life, Cancer Care Insurance, and more.

Additional company perks

• Robust mental health offerings including an Employee Assistance Program, Learn to Live, meQ.
• Comprehensive learning and development opportunities and an Educational Assistance Program.
• 16 hours of paid volunteer time with a $200 donation to a charity of your choice upon completion of all volunteer hours.
• Employee recognition, community initiative events and yearly company outings.
• Workplace flexibility offering different options for working arrangements and the freedom to make time for important commitments.
• Opportunities to connect through employee committees.

Equal opportunity employment

Equal Opportunity Employer of Minorities, Females, Protected Veterans and Individual with Disabilities, as well as Sexual Orientation or Gender Identity.

For questions, please email careers@bcbsnd.com.

This job posting will be closed 2/7/2025 at 8:00 a.m. (CT). No further applications will be considered.