Matthew Hunt
Cordele,GA
Summary
Detail-oriented Regulatory Compliance Analyst with strong skills in audit management, risk assessment, and data reporting. Committed to ensuring compliance with healthcare regulations and facilitating effective stakeholder collaboration.
Overview
11
11
years of professional experience
Work History
Regulatory Compliance Analyst
Anthem Healthcare Inc
Atlanta, GA
12.2022 - 01.2026
- Analyzed policy documents for adherence to state and federal regulations, identifying potential compliance gaps.
- Reviewed and updated compliance policies to ensure alignment with applicable laws, regulations and industry standards.
- Conducted regulatory compliance audits for healthcare programs and services, ensuring alignment with legal requirements and operational standards.
- Assessed organizational risk posed by non-compliance with applicable laws, regulations and industry standards.
- Collaborated with stakeholders from various departments to develop effective strategies for meeting compliance objectives.
- Collaborated with cross-functional teams to ensure accurate reporting of compliance data.
- Monitored changes in regulations and communicated updates to relevant departments.
- Ensured that periodic reviews were conducted on new products or services prior to launch.
- Assisted in developing systems for tracking changes in relevant laws, regulations or industry standards.
- Drafted reports summarizing audit results and providing actionable recommendations for corrective action.
Dental Business Analyst
Anthem Healthcare Inc.
Atlanta, GA
05.2017 - 12.2022
- Built internal and external relationships with program managers, product directors, and actuarial team to incorporate dental product requirements into business systems.
- Effectively review, analyze, update, and communicate dental product benefits and plan designs to our upstream and downstream business partners.
- Obtained, tested, and communicated accuracy of dental product information as liaison with internal and external partners to ensure accurate display of products to end consumers.
- Work with our contracts team to ensure our Dental Benefit Plan Designs are accurately displaying correct benefits to CMS for multiple states including meeting federal regulations for all states.
- Gained expertise in Affordable Care Act and regulations affecting dental benefits and plan design, particularly pediatric dental essential health benefits.
Claim Accumulator Adjuster
Anthem Healthcare Inc
Columbus, GA
05.2015 - 05.2017
- Decreased loss ratios through fair and timely claim processing.
- Evaluated claims to determine coverage and compliance with policy guidelines.
- Assessed potential losses for insureds in accordance with applicable laws and regulations.
- Collaborated with healthcare professionals to obtain documentation, ensuring accurate claims processing.
- Coordinated with legal teams to investigate complex claims, facilitating resolution and compliance.
- Communicated with clients to explain coverage options and claims processes.
- Conducted quality control reviews of claims files, enhancing accuracy and completeness prior to closure.
- Trained junior adjusters on best practices and company policies for claims handling.
Education
High School Diploma -
Harris County High School
Hamilton05-1997
Skills
- Regulatory compliance
- Policy analysis
- Audit management
- Risk assessment
- Data reporting
- Stakeholder collaboration
- Business analysis
- Regulatory reporting
- Compliance testing
- Time management
- Healthcare regulations
- Product roadmap
- Business process improvement
- Software development life cycle
- JIRA software
- Stakeholder management
- Competitive analysis
Accomplishments
Open Enrollment Ambassador
Timeline
Regulatory Compliance Analyst
Anthem Healthcare Inc
12.2022 - 01.2026
Dental Business Analyst
Anthem Healthcare Inc.
05.2017 - 12.2022
Claim Accumulator Adjuster
Anthem Healthcare Inc
05.2015 - 05.2017
High School Diploma -
Harris County High School