Operations Services Manager
EEOC
Senior Claims Compliance Analyst
Arch Capital Group Ltd.
full-time
Posted on:
Origin: • 🇺🇸 United States • Illinois
Visit company websiteSalary
💰 $85,295 - $148,902 per year
Job Level
Senior
About the role
- Coordinate with the claims organization, including Third Party Administrators (TPAs)
- Monitor and identify relevant regulatory changes and determine potential impact to the claims organization
- Communicate regulatory changes to appropriate business units and identify required system or process changes
- Gather data to prepare and analyze compliance-managed regulatory reports and data calls; timely submit state-specific annual/quarterly reports
- Coordinate responses to inquiries by State Departments of Insurance and serve as intermediary between business, handling entity, and State Departments
- Coordinate Claims Audits conducted by State Departments; analyze and assess audit reports and complaints to identify performance issues
- Review state report cards and metrics on claims processing and reporting and work with TPAs and Arch staff to remediate issues
- Foster working relationships with regulatory bodies and Arch business groups supporting Compliance efforts
- Monitor claims operational control structure and recommend changes based on audit feedback
- Drive continuous improvement and development of claim control library/documentation
- Support internal audit processes and assist with enterprise-wide Compliance best practices and delivery of compliance training
- Conduct periodic compliance quality reviews for both internal claim departments and TPAs
- Instrumental in building the Claims Compliance function, reporting to the Vice President of Claims Compliance
Requirements
- Must have at least 5-7 years’ Claims Compliance experience
- P&C claims knowledge
- Knowledge of state insurance regulations
- Efficient organization and project management skills
- Familiarity with Walters Kluwer, Lexis/Nexis or similar subscription services
- Proficiency with the suite of Microsoft products such as Excel, Word, PowerPoint
- Ability to effectively communicate ideas, issues and solutions
- Ability to communicate effectively with external business partners
- Working knowledge of SOX controls and testing is preferred
