Corporate Claims Compliance Specialist

externalpmacompanies; Tampa (FL); On-site; USD 90,000 - 110,000; Full time

Job summary

externalpmacompanies in Tampa, FL, seeks a seasoned regulatory compliance professional in the insurance field to interpret state and federal laws, assess impact on operations, and coordinate revisions to rates, forms, and claim handling.

The candidate should have a bachelor's degree or 5+ years in insurance, CPCU or AIC desirable, licensing, leadership ability, and strong communication and problem‑solving skills; familiarity with WC regulations and MS Office is a plus.

Qualifications

• Bachelor's degree or 5+ years in insurance-related work experience.
• Desirable CPCU and AIC professional designation.
• Licensing as required and CE credits as needed.
• Supervisory experience and strong regulatory knowledge across jurisdictions.
• Solid understanding of insurance contracts and regulatory audits.

Responsibilities

• Analyzes and interprets insurance regulations and their impact on company operations.
• Monitors compliance actions and implements system revisions for rates, rules, and claims.
• Reviews department bulletins and laws for changes to forms and materials.
• Coordinates regulatory submissions and initial consumer complaint analyses.
• Ensures ongoing compliance across operating companies and teams.
• Demonstrates leadership and adherence to ethics and company policies.

Skills

Regulatory knowledge

Leadership

Communication

Analytical thinking

Problem solving

Education

Bachelor's degree

CPCU

AIC

Tools

MS Office

EDI compliance

Job description

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.

Qualifications

• 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-requiredContinuing 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.