Claims Compliance Analyst jobs in United States
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Arch Insurance Group Inc. ยท 7 hours ago

Claims Compliance Analyst

Arch Insurance Group Inc. is a company that promotes progress and inspires its clients, employees, investors, and communities. The Claims Compliance Analyst will support the Claims organization with compliance requirements, including regulatory reporting and audit coordination.

FinanceFinancial ServicesInsurance

Responsibilities

Serve as an initial contact and assist with the coordination of Claims Audits that are conducted by the various State DOIs. Will serve as primary intermediary between the business, handling entity, and the State Departments
Receive and interpret preliminary audit requests by the State Departments. Analyze and assess audit reports that are issued by the State Departments to identify performance issues. Communicate the results to Arch Claims Senior Leadership TPA Corporate Contacts (if applicable)
Assist with the review of state report cards and metrics on claims processing and reporting and work with TPAs and Arch staff to remediate any issues
Gather data from TPAs and/or Arch data reports to prepare Compliance managed regulatory reports and data calls. Timely submit state specific annual/quarterly reports where required
Review and analyze Claims Bulletins related to Regulatory Reports, communicate internally and/or to the TPAs as needed, and monitor implementation of new requirements where appropriate
Assist with Electronic Data Interchange (EDI) reporting
Support maintenance of compliance library and claims correspondence
Provide compliance support for Medicare Reporting
Assist with internal audit and regulatory reviews
Other ad hoc compliance related tasks, as needed

Qualification

P&C claims knowledgeCommercial Lines Claims ExperienceMedicare Secondary Payer (MSP)Microsoft products proficiencyProject management skillsEffective communication

Required

General P&C claims knowledge
Efficient organization and project management skills
Familiarity with the suite of Microsoft products such as Excel, Word, PowerPoint, etc
Ability to effectively communicate ideas, issues and solutions
Bachelor's degree required
2 + years Commercial Lines Claims Experience
Ability to communicate effectively with internal and external business partners as well as state regulatory authorities

Preferred

Adjusting experience preferred
Familiarity with Medicare Secondary Payer (MSP) and Section 111 Reporting

Benefits

Multiple medical plans plus dental, vision and prescription drug coverage
A competitive 401k with generous matching
PTO beginning at 20 days per year
Up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer
Basic Life and AD&D Insurance
Short and Long-Term Disability
Paid Parental Leave of up to 10 weeks
Student Loan Assistance and Tuition Reimbursement
Backup Child and Elder Care

Company

Arch Insurance Group Inc.

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Arch Insurance Group Inc., a division of Arch Capital Group Ltd. (ACGL), is a market-leading specialty insurer.

Funding

Current Stage
Late Stage

Leadership Team

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Rebecca Raisley
Vice President of Business Development
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Valerie Turpin
Division President - Property and Marine
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Company data provided by crunchbase