Claims Compliance Analyst

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Position Overview

The Shared Services Team is seeking a new team member who thrives in a highly collaborative team-oriented environment.  The Claims Compliance Analyst will report directly the Vice President of Claims Compliance. The Claims Compliance Analyst position requires supporting the Claims organization with all facets of general compliance requirements, including reconciling, regulatory reporting and responding to compliance related inquiries.

Responsibilities:

Audit Coordination

• Serve as an initial contact and assist with the coordination of Claims Audits that are conducted by the various State DOIs. Will serve as primary intermediary between the business, handling entity, and the State Departments.

• Receive and interpret preliminary audit requests by the State Departments. Analyze and assess audit reports that are issued by the State Departments to identify performance issues. Communicate the results to Arch Claims Senior Leadership TPA Corporate Contacts (if applicable).       

• Assist with the review of state report cards and metrics on claims processing and reporting and work with TPAs and Arch staff to remediate any issues.

Regulatory Reporting

• Gather data from TPAs and/or Arch data reports to prepare Compliance managed regulatory reports and data calls. Timely submit state specific annual/quarterly reports where required.

• Review and analyze Claims Bulletins related to Regulatory Reports, communicate internally and/or to the TPAs as needed, and monitor implementation of new requirements where appropriate

• Assist with Electronic Data Interchange (EDI) reporting

Other Compliance Activities

• Support maintenance of compliance library and claims correspondence

• Provide compliance support for Medicare Reporting

• Assist with internal audit and regulatory reviews

• Other ad hoc compliance related tasks, as needed.

Experience and Required Skills:

• General P&C claims knowledge, adjusting experience preferred

• Efficient organization and project management skills

• Familiarity with the suite of Microsoft products such as Excel, Word, PowerPoint, etc. 

• Ability to effectively communicate ideas, issues and solutions.

Education

• Bachelor's degree required

• 2 + years Commercial Lines Claims Experience

• Ability to communicate effectively with internal and external business partners as well as state regulatory authorities

• Familiarity with Medicare Secondary Payer (MSP) and Section 111 Reporting

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For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible.

$71,900 - $97,110/year

• Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future.

• Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits.

Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you. If this job isn’t the right fit but you’re interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch’s Talent Acquisition team.

For Colorado Applicants - The deadline to submit your application is: