Medicare Compliance, Advertising Filing Specialist

Role Overview

• Own all Medicare advertising submissions through the CMS Health Plan Management System (HPMS), including file & use and prior approval filings for MA, MAPD, and PDP materials
• Submit and manage advertising materials through each contracted carrier’s co-op advertising portal or designated advertising review process
• Track every filing from initial submission through final disposition—maintaining records of submission dates, carrier/CMS response dates, approval status, objections received, corrections made, and final approval confirmation
• Respond to carrier and CMS objections promptly, coordinating corrected materials with internal staff and resubmitting within required timeframes
• Monitor HPMS filing calendars, carrier advertising deadlines, and material expiration dates; initiate renewals and withdrawals proactively
• Maintain a master advertising filing log covering all active, pending, approved, expired, and withdrawn materials across all carriers and plan types
• Review all agency-produced advertising content against CMS Medicare Marketing Guidelines (MMG) before submission, including for example: direct mail pieces, print ads, digital display, paid social, email campaigns, radio/TV scripts, websites, landing pages, and sales event invitations
• Identify non-compliant content (e.g., misleading benefit representations, prohibited comparisons, unauthorized use of Medicare or government seals, impermissible inducements, missing required disclosures, etc.) and direct corrections before any material is filed or published
• Apply and verify all required disclaimers, co-branding requirements, and plan-specific benefit disclosure standards
• Review other insurance (e.g., Medicare Supplement) advertising for compliance with applicable NAIC model standards and state-specific advertising regulations
• Serve as the final compliance sign-off before any advertising asset is submitted to a carrier or CMS, or released for publication
• Monitor CMS HPMS memos, Annual Marketing Review releases, and Medicare Marketing Guideline updates throughout the plan year; translate changes into clear, actionable guidance for agency staff and producers
• Maintain an up-to-date reference library of advertising guidelines, required disclaimers, approved language, and plan-specific advertising rules for each contracted carrier (e.g., MA, MAPD, PDP, and Medicare Supplement)
• Advise producers and agency leadership on what advertising content is and is not permissible under current CMS rules and carrier requirements
• Support the agency’s response to carrier compliance audits, CMS oversight inquiries, and state Department of Insurance advertising reviews
• Develop and maintain written SOPs for the advertising material lifecycle, from internal review through carrier/CMS submission, approval, publication, expiration, and withdrawal
• Build and maintain filing documentation that would satisfy a carrier audit or CMS review at any point in the year
• Report advertising compliance activity, filing volumes, approval rates, and outstanding items to agency leadership on a regular basis
• Identify recurring content errors or process gaps and recommend corrections to prevent compliance exposure.

Requirements

• 3+ years of direct, hands-on experience submitting Medicare advertising materials through HPMS (file & use and/or prior approval) — required
• 3+ years of experience submitting materials through carrier co-op advertising portals for MA, MAPD, and/or PDP plans — required
• Proven ability to review consumer-facing Medicare advertising across multiple media types for CMS MMG compliance before submission
• Working knowledge of TPMO disclaimer requirements, co-branding rules, SOA requirements, and required plan benefit disclosures
• Experience resolving carrier and CMS advertising objections and managing resubmission processes
• Strong organizational and tracking skills; ability to manage high filing volumes across multiple carriers simultaneously
• Bachelor’s degree in healthcare administration, business, communications, marketing, or equivalent professional experience
• Certified in Healthcare Compliance (CHC) or actively pursuing certification (preferred)
• Active health insurance producer license (or willingness to obtain) (preferred)
• Prior experience in an agency, brokerage, FMO, TPMO or similar advertising compliance or operations role (preferred)
• Experience with Medicare Supplement advertising under NAIC model standards and state-level requirements (preferred)
• Familiarity with TCPA, CAN-SPAM, and state telemarketing rules as applied to Medicare marketing (preferred)
• Experience building or maintaining compliance tracking systems or document management workflows (preferred)
• Familiarity with FWA training requirements and annual certification obligations for Medicare producers (preferred).

Benefits

• Paid Time Off.
• Paid Company Holidays.
• Medical, Dental, Vision, Life Insurance, HSA, FSA, and more.
• 401 (K) savings plan with company matching up to 3%.
• Work-Life Resources for you and your family.
• Discounts with Hotels, Rental Cars, Entertainment, Attractions, & More!
• Maternity/Paternity/Adoption paid leave.
• Referral program.
• Company-supplied computer equipment.