Claims Compliance Specialist

SageSure

Claims Compliance Specialist overseeing adjuster licensing and complaint management within SageSure's growing Claims team to ensure compliance and excellence.

Posted 4/27/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSeniorWebsite

About the role

Key responsibilities & impact

Oversee the adjuster licensing process across multiple jurisdictions and lead the complaint handling program to ensure timely, compliant, and customer-focused outcomes.
Own and manage the adjuster licensing lifecycle, including initial licensing, renewals, and continuing education across multiple jurisdictions.
Ensure ongoing compliance with all state licensing requirements and proactively identify potential risks or gaps.
Provide regular, data-driven reporting on licensing status, trends, and risks to leadership.
Serve as the primary point of contact for licensing-related inquiries and communicate regulatory updates clearly to stakeholders.
Support oversight of third-party vendors and licensing partners, ensuring adherence to regulatory requirements and internal standards.
Partner with vendors to improve licensing processes, enhance data accuracy, and drive operational efficiency.
Identify opportunities to streamline and automate licensing workflows, reducing manual effort and improving scalability.
Develop and maintain procedural documentation, controls, and monitoring mechanisms to ensure consistency, accuracy, and audit readiness.
Own the end-to-end complaint handling program, ensuring timely, accurate, and compliant resolution of customer complaints.
Oversee complaint tracking, reporting, and trend analysis; identify root causes and drive remediation efforts.
Develop and maintain compliance documentation, including policies, procedures, and training materials.
Present complaint insights, risks, and recommendations to senior leadership with clarity and precision.
Support regulatory complaint inquiries regarding data calls, market conduct exams, and carrier audit activities.
Partner cross-functionally to implement solutions, including process enhancements and automation opportunities, to address recurring complaint drivers.

Requirements

What you’ll need

Bachelor’s degree required (Business, Risk Management, Finance, or related field preferred)
3+ years of experience of state and federal insurance claims regulations, including licensing requirements, complaint requirements, claims handling procedures, and compliance standards.
3+ years of P&C insurance experience
Proven ability to operate effectively in ambiguous, fast-paced environments with evolving priorities
Experience building or significantly enhancing compliance or operational processes from the ground up
Demonstrated success driving process improvement, automation, or transformation initiatives
Ability to assess, design, and transform processes, including transitioning from manual to automated workflows
Experience partnering cross-functionally with Operations, Technology, Legal, and Risk teams
Experience working with or overseeing third-party vendors or TPAs in a regulated environment
Strong critical thinking skills with the ability to balance regulatory requirements with practical business needs
Ability to interpret, apply, and communicate complex regulatory requirements clearly to diverse stakeholders
Strong organizational and time-management skills with the ability to manage multiple priorities and deadlines
Proficiency in Microsoft Office Suite, Smartsheet, Domo, or similar tools
Excellent written and verbal communication skills
High attention to detail and accuracy
Ability to work both independently and collaboratively.

Benefits

Comp & perks

Health insurance
401(k) matching
Professional development opportunities

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

adjuster licensingcompliance documentationprocess improvementautomationdata analysiscomplaint handlingrisk managementclaims handling proceduresregulatory complianceoperational efficiency

Soft Skills

critical thinkingorganizational skillstime managementcommunication skillscollaborationproblem-solvingadaptabilityleadershipattention to detailstakeholder management