Remote Claims Compliance Strategy Lead

WCF Insurance; United States; Teletrabalho; USD 98 000 - 122 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Medical/dental/vision insurance

401K with 6% match

EAP

Volunteer time off

4 weeks vacation

Resumo da oferta

WCF Insurance is seeking a Claims Compliance Strategy Specialist to assess, advise, and support business adherence across the claims organization, ensuring regulatory, reporting, and operational standards are met. The role partners with IT and business stakeholders on project implementations and helps drive process improvements to strengthen compliance.

Open to office locations in Sandy, UT; Las Vegas, NV; Englewood, CO; Meridian, ID; Sacramento, CA; or fully remote for those outside commuting

Qualificações

• Bachelor’s degree or appropriate combination of insurance industry claims designation(s).
• Minimum five years of commercial insurance experience, at least two of which in compliance or regulatory reporting.
• In depth knowledge of Medicare, insurance reporting bureaus, and state-specific laws and reporting requirements.
• Excellent regulatory, legal research and analytical skills.
• Excellent communication, interpersonal, and organizational skills.
• Ability to work at both strategic and technical levels.
• Strong background and experience in process improvement and data analysis.
• Ability to understand reporting requirements, system functionality and communicate required changes.
• Ability to work independently.

Responsabilidades

• Monitor accuracy, acceptance, and changes related to regulatory agencies’ requirements.
• Monitor and analyze commercial claim laws and regulations that may affect WCF’s claims handling policies and practices.
• Research, identify and QA potential areas of risk for the claims department.
• Review, advise and participate in IT project implementation.
• Partner with IT to ensure systems and processes meet business adherence standards.
• Bring cross-functional teams together to prioritize, develop and implement necessary changes.
• Assist other internal departments with understanding and implementing requirements for business adherence.
• Assist with any regulatory audits, DOI and market conduct exams.

Conhecimentos

Regulatory knowledge

Data analysis

Regulatory reporting

Communication skills

Project collaboration

Independent work

Formação académica

Bachelor’s degree

Descrição da oferta de emprego

WCF Insurance is seeking a Claims Compliance Strategy Specialist to assess, advise, and support business adherence across the claims organization, ensuring regulatory, reporting, and operational standards are met. The role partners with IT and business stakeholders on project implementations and helps drive process improvements to strengthen compliance.

Open to office locations in Sandy, UT; Las Vegas, NV; Englewood, CO; Meridian, ID; Sacramento, CA; or fully remote for those outside commuting