Corporate Claims Compliance Specialist

Old Republic Commercial Risk; Schaumburg (IL); On-site; USD 95,000 - 130,000; Full time

Job summary

Old Republic Commercial Risk is seeking a Corporate Compliance Specialist to operate under the AVP of Compliance and Claim Operations. The role emphasizes handling high-complexity assignments, regulatory interpretation, and system revisions related to rates, rules, and claim handling.

Ideal candidates bring a bachelor’s degree or 5+ years in insurance, plus CPCU/AIC desirability. Licenses and CE credits are required to maintain regulatory readiness and supervisory experience is valued.

Qualifications

• Bachelor's degree or 5+ years in an insurance-related industry required.
• CPCU and AIC designations are desirable.
• Obtains state adjusting licenses and maintains required CE credits.
• Previous supervisory experience is important.
• Strong knowledge of WC regulations and applicable law across jurisdictions.
• Leadership, coaching and teamwork skills are essential.
• Knowledge of insurance contracts, regulatory/audit experience, and EDI requirements.
• High proficiency in analysis, decision-making, planning and negotiation.
• Proficient in MS Office and collaboration cross-functionally.

Responsibilities

• Analyzes and interprets state, federal and industry insurance regulations and their impact on operations.
• Monitors timely implementation of action plans to ensure compliance with regulatory changes.
• Plans and implements system revisions for rates, rules and claim handling changes.
• Reviews notices and bulletins for changes related to forms, materials, and operations.
• Coordinates regulatory filings and prepares materials for state departments and Claim Ops teams.
• Handles consumer complaints and inquiries from state departments.
• Completes compliance assessments including research, file reviews and audits.
• Collaborates with operating companies to meet compliance needs and requirements.
• Upholds the company's Code of Conduct and applies policy knowledge to responsibilities.

Skills

Regulatory knowledge

Leadership

Communication

Problem solving

Planning & organizing

MS Office

Customer service

Coaching

Education

Bachelor's degree in insurance or related field

CPCU or AIC designation desirable

Tools

MS Office Suite

Regulatory reporting systems

EDI compliance systems

Job description

Under the technical direction of the AVP of Compliance and Claim Operations, the Corporate Compliance Specialist will works within defined limits and authority on assignments of higher technical complexity and coordination. Possesses demonstrated technical insurance industry knowledge and skills, including state, federal and industry compliance regulations, reflective of successful progression through various job family levels. May provide guidance and assistance to lower-level associates and other functional areas.
Responsibilities -

• Analyzes and interprets state, federal and industry insurance legislation and regulations determining the potential impact on company operations.
• Monitors timely implementation of action plans to ensure compliance with regulatory changes.
• Plans and implements system revisions for rates, rules and claim handling changes.
• Reviews APCIA, industry notices, Insurance Department bulletins and enacted laws for changes relative to claim forms, printed material, and necessary operational changes.
• Coordinates and prepares the necessary forms and regulatory material for submission to state insurance departments to review or Claim Operations for implementation.
• Receives and performs initial analysis of consumer complaints and state insurance department inquiries.
• Completes compliance assessments, including research, file reviews, audits and business unit secondary review.
• Works closely with supported Operating Companies to ensure their compliance needs and requirements are met.
• Demonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.

Requirements

• Bachelor's' degree or 5 or more years of equivalent work experience in an insurance related industry required.
• Chartered Property Casualty Insurance (CPCU) and Associate in Claims (AIC), or similar professional designation, desired.
• Obtains and maintains state adjusting licenses, as necessary. Ensures that all state-required Continuing Educational Credits are obtained as needed to maintain license.
• Previous supervisory experience
• Extensive knowledge of WC regulations and applicable law, preferably in multiple jurisdictions.
• Demonstrated leadership, coaching, and teamwork skills.
• Extensive knowledge of insurance contracts, insurance technical constructs and structures; previous state regulatory/audit experience; experience with EDI compliance requirements
• Advanced skills in applying sound judgment/analysis, decision making/problem solving, planning and organization and negotiation.
• Computer literacy, including working knowledge of MS Office Product Suite, i.e. Word, Excel, PowerPoint.
• Demonstrated customer service and collaboration skills.
• Excellent verbal and written communication skills.