The Corporate Claims Compliance Specialist analyzes and interprets insurance legislation to ensure company operations remain compliant with state and federal regulations. They also coordinate regulatory submissions, perform audits, and provide guidance to other functional areas regarding claim handling changes.
Under the technical direction of the AVP of Compliance and Claim Operations, the Corporate Compliance Specialist will works within defined limits and authority on assignments of higher technical complexity and coordination. Possesses demonstrated technical insurance industry knowledge and skills, including state, federal and industry compliance regulations, reflective of successful progression through various job family levels. May provide guidance and assistance to lower-level associates and other functional areas.
Responsibilities -
Analyzes and interprets state, federal and industry insurance legislation and regulations determining the potential impact on company operations. * Monitors timely implementation of action plans to ensure compliance with regulatory changes. * Plans and implements system revisions for rates, rules and claim handling changes. * Reviews APCIA, industry notices, Insurance Department bulletins and enacted laws for changes relative to claim forms, printed material, and necessary operational changes. * Coordinates and prepares the necessary forms and regulatory material for submission to state insurance departments to review or Claim Operations for implementation. * Receives and performs initial analysis of consumer complaints and state insurance department inquiries. * Completes compliance assessments, including research, file reviews, audits and business unit secondary review. * Works closely with supported Operating Companies to ensure their compliance needs and requirements are met.
Demonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.
#LI-Remote
Qualifications
Bachelor's' degree or 5 or more years of equivalent work experience in an insurance related industry required.
Chartered Property Casualty Insurance (CPCU) and Associate in Claims (AIC), or similar professional designation, desired.
Obtains and maintains state adjusting licenses, as necessary. Ensures that all state-required Continuing Educational Credits are obtained as needed to maintain license.
Previous supervisory experience
Extensive knowledge of WC regulations and applicable law, preferably in multiple jurisdictions.
Demonstrated leadership, coaching, and teamwork skills.
Extensive knowledge of insurance contracts, insurance technical constructs and structures; previous state regulatory/audit experience; experience with EDI compliance requirements
Advanced skills in applying sound judgment/analysis, decision making/problem solving, planning and organization and negotiation.
Computer literacy, including working knowledge of MS Office Product Suite, i.e. Word, Excel, PowerPoint.
Demonstrated customer service and collaboration skills.
Excellent verbal and written communication skills.
“I was the first applicant for a remote marketing position that got listed on the company website the same day I applied. Had an interview within 48 hours!”
— Sarah J.
·
Marketing Manager
★★★★★
Verified
