Claims Compliance Senior Representative

Westfield • Seville, OH

411d

About The Position

The Claims Compliance Senior Representative plays a crucial role in the Claims Compliance Department, responsible for overseeing compliance processes related to claims handling, adjuster licensing, and regulatory reporting. This position requires a high level of technical expertise and involves coordinating complex claim assignments while ensuring adherence to statutory and regulatory obligations. The representative acts as a subject matter expert, guiding junior compliance representatives and collaborating with various internal and external stakeholders to enhance compliance practices.

Requirements

• 3-5 years of experience in Claims Compliance or a related field.
• Bachelor's degree in Business Administration or a related field and/or commensurate work experience.

Nice To Haves

• Experience in insurance industry compliance processes.
• Familiarity with regulatory reporting and reinsurance requirements.

Responsibilities

• Coordinates development and maintenance of claims handling complaint processes and related tools.
• Maintains process for identifying, submitting, and monitoring regulatory reporting obligations related to Claims.
• Researches and gathers requirements, organizes, and analyzes data, and identifies trends and opportunities.
• Develops and maintains knowledge of state licensing requirements and other statutory reporting requirements for compliance.
• Maintains effective communication with claim department leaders, internal and external partners, and vendors.
• Collaborates with team and internal partners regarding adjuster licensing and regulatory reporting.
• Provides day-to-day support to compliance professionals and corrects reporting errors.
• Performs ad-hoc claim file reviews to assist claims professionals with compliance issues.
• Participates in process improvement initiatives to streamline claims processing operations.

Benefits

• Health insurance
• Dental insurance
• Vision insurance
• 401k plan with matching contributions
• Paid holidays
• Paid time off (PTO)
• Employee assistance programs
• Professional development opportunities

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Educational Services
• Education Level: Bachelor's degree
• Number of Employees: 1,001-5,000 employees