Analyzes insurance regulations and legislation, evaluates operational impacts, monitors compliance action plans, coordinates claims and rate system revisions, prepares regulatory submissions, investigates consumer complaints, conducts compliance assessments and audits, and supports operating companies with regulatory requirements. Provides guidance to associates and applies expertise in workers’ compensation regulations, insurance contracts, state audits, EDI compliance, and claims operations.
Job Summary & Responsibilities Preferred Qualifications
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
- 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.
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