Corporate Claims Compliance Specialist

Old Republic Commercial Risk; Town of De Witt (NY); On-site; USD 110,000 - 150,000; Full time

Job summary

Old Republic Commercial Risk is seeking a Corporate Compliance Specialist who works under the AVP of Compliance and Claim Operations to handle high-complexity assignments and coordinate across teams. You will analyze regulations, monitor action plans, and implement system changes to ensure ongoing regulatory compliance.

Strong leadership and communications are essential. The role requires a Bachelor's degree or 5+ years in insurance, supervisory experience, and knowledge of WC regulations across

Qualifications

• Bachelor's degree or 5+ years in insurance industry required.
• CPCU and/or AIC designation desired.
• Maintains state adjusting licenses and required CE credits.
• Previous supervisory experience.
• Extensive knowledge of WC regulations across jurisdictions.
• Strong judgment, planning and negotiation abilities.
• MS Office proficiency and technical literacy.
• Strong communication and collaboration skills.

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.

Skills

Leadership

Coaching

Teamwork

Verbal and written communication

Regulatory analysis

Problem solving

Education

Bachelor's degree or 5+ years in insurance industry

Tools

MS Office Suite (Word, Excel, PowerPoint)

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.