Job Summary / Introduction
- Senior compliance role supporting US insurance claims operations
- Responsible for strengthening regulatory controls and claims governance
- Acts as a subject matter expert for claims compliance and regulatory risk
- Supports a complex, multi-jurisdictional claims environment
Detailed Job Description
- Own claims compliance oversight across all US jurisdictions
- Track and interpret regulatory, legislative, and legal developments impacting claims
- Translate regulatory change into operational guidance, controls, and training
- Maintain enterprise claims compliance requirements and documentation
- Design and manage controls tied to federal and state claims obligations
- Collaborate with Claims, Legal, and Technology teams on compliant workflows
- Lead regulatory inquiries, complaints, and claims-related examinations
- Develop compliance monitoring, audits, and reporting dashboards
- Support claims systems enhancements and compliance integrations
- Deliver insights and trend reporting to senior leadership
Skills & Experience
- 8+ years of experience in insurance claims compliance or regulation
- Bachelor’s degree in a relevant discipline required
- Professional compliance or insurance certifications preferred
- Strong knowledge of claims regulations, market conduct, and federal protocols
- Experience supporting multiple lines of business across all US states
- Medicare Secondary Payer and Section 111 reporting expertise
- Regulatory audit and examination experience
- Strong analytical, writing, and stakeholder communication skills
If interested, please apply to this job advert or reach out to [email protected]
