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Hiscox USA · 4 months ago

Senior Claims Compliance Analyst

USA, Atlanta

Full-time

Hybrid

Senior Level, Lead/Staff

$120K/yr - $160K/yr

10+ years exp

Hiscox USA is a leading insurance provider focused on small and middle market commercial clients. They are seeking a Senior Claims Compliance Analyst to manage compliance with insurance regulations, develop controls, and provide training and legal support across the organization.

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Responsibilities

Manage and maintain 50-state claims database

Monitor legislation, DOI bulletins, court reporters/decisions, and statutory changes; manage backlog and implement targeted compliance training

Develop and own controls related to Medicare, OFAC, Child Support Lien Network, and other federal protocols

Partner with Claims Technical, US Legal, and IT to design controls and workflows aligned with regulatory requirements

Lead US Claims response to regulatory inquiries and complaints

Deliver training and legal support to internal teams and vendors

Develop audit programs and dashboards to monitor compliance effectiveness

Oversee/support technology-related compliance integrations

Provide executive reporting, trends analysis, and regulatory insights

Qualification

Claims compliance experienceInsurance regulation knowledge. degreeMedicare protocols knowledgeRegulatory audit preparationResearch skillsPolicy writing skillsProject management skillsCollaboration skillsProblem-solving skills

Required

10+ years of experience in claims compliance, insurance regulation, or legal operations

Deep understanding of claims handling regulations, Medicare protocols, and market conduct standards

Experience with multiple lines of business in a 50-state claims environment

Knowledge of Medicare Secondary Payer requirements and Section 111 reporting

Strong research and policy writing skills

Excellent collaboration, project management, and problem-solving skills

Experience with regulatory audit preparation and response

Preferred

J.D. strongly preferred, advanced insurance compliance certification a plus

Benefits

401(k) with competitive company matching

Comprehensive health insurance, vision, dental and FSA plans (medical, limited purpose, and dependent care)

Company paid group term life, short- term disability and long-term disability coverage

24 Paid time off days plus 2 Hiscox days,10 paid holidays plus 1 paid floating holiday, and ability to purchase up to 5 PTO days

Paid parental leave

4-week paid sabbatical after every 5 years of service

Financial Adoption Assistance and Medical Travel Reimbursement Programs

Annual reimbursement up to $600 for health club membership or fees associated with any fitness program

Company paid subscription to Headspace to support employees’ mental health and wellbeing

2024 Gold level recipient of Cigna’s Healthy Workforce Designation for having a best-in-class health and wellness program

Dynamic, creative and values-driven culture

Modern and open office spaces, complimentary drinks

Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation