Asisistant Compliance Officer – Fraud Investigations
Skills & Experience
- Bachelor’s degree in Business or a related field
- 5+ years of experience within a life insurance company in administrative or operational functions
- Working knowledge of new business processing, underwriting, policy administration, and agent contracting
- Experience with market conduct compliance, fraud detection, and regulatory monitoring
- Strong analytical, investigative, and problem-solving skills
- Ability to manage multiple priorities and work independently in a fast-paced environment
- Excellent attention to detail and written communication skills
- Familiarity with Anti-Money Laundering (AML) requirements and insurance regulatory frameworks
- Professional industry training or designations such as LOMA coursework, ACS, or FLMI preferred
Job Summary / Introduction
A life insurance organization is seeking a Compliance Officer to support Special Investigations Unit (SIU) and market conduct compliance initiatives. This role is responsible for monitoring regulatory compliance, conducting agent and operational audits, identifying potential fraud risks, and supporting investigations related to policyholder complaints, claims, and business practices.
The position plays a key role in maintaining regulatory compliance across business operations, partnering with internal teams to review procedures, strengthen controls, and ensure adherence to state and federal insurance regulations.
Detailed Job Description
- Monitor and review changes in state insurance regulations related to policy benefits, policyholder notices, nonforfeiture options, and other service functions to ensure compliance.
- Conduct investigations related to claims, policy rescissions, and other operational activities to identify potential compliance issues or fraud risks.
- Audit agent business activity to evaluate compliance with regulatory requirements and internal standards.
- Review sales practices including illustrations, policy replacements, and new business processing for regulatory compliance.
- Investigate consumer complaints and underwriting issues to determine whether market conduct concerns exist.
- Coordinate with internal departments to determine appropriate corrective actions or sanctions related to agent conduct.
- Support reporting and documentation requirements for potential fraud cases submitted to state insurance departments and regulatory bodies.
- Serve in a leadership capacity within the Special Investigations Unit, coordinating investigations and compliance oversight activities.
- Provide guidance to internal stakeholders regarding compliance considerations for advertising, marketing materials, and agent activities.
- Participate in cross functional compliance reviews of policy forms, applications, sales literature, and communications distributed to agents or policyholders.
- Support Anti-Money Laundering compliance activities and assist in identifying suspicious transactions or patterns.
- Assist with employee training programs focused on fraud prevention, AML requirements, and compliance best practices.
- Collaborate with legal, underwriting, and operational teams on regulatory matters and compliance initiatives.
- Assist in responding to insurance department inquiries, complaints, and regulatory reviews.
- Prepare reports and recommendations related to audit findings, fraud detection, and process improvement opportunities.
If interested, please apply to this job advert or reach out to [email protected]
