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AIG · 18 hours ago

Claims TPA Regulatory Manager

GA-Atlanta

Full-time

Onsite

Senior Level

5+ years exp

AIG is a global leader in commercial and personal insurance solutions, and they are seeking a Claims TPA Regulatory Manager to oversee regulatory matters relating to third-party administrators handling claims. This role involves ensuring compliance with state and federal regulations and managing relationships with TPA partners.

BankingFinancial ServicesInsurance

Responsibilities

Monitor changes in state, federal, and market conduct regulatory requirements impacting claims handling and TPA activities

Ensure TPA partners maintain compliance with claims regulations, including timeliness standards, documentation rules, licensing requirements, privacy laws, and unfair claims practices statutes

Monitor regulatory audits of TPAs, evaluating claim file accuracy, adherence to regulatory timelines, reserve practices, and customer-service standards

Identify compliance risks and lead corrective action plans with internal stakeholders and TPA leadership

Prepare and support responses to Department of Insurance (DOI) inquiries, audits, market conduct exams, and regulatory filings related to TPA-handled claims

Serve as the primary liaison between Claims, Compliance, Legal, and external TPA partners

Oversee response to and compliance with state regulatory audits and fines

Manage and lead supporting team member(s)

Qualification

TPA regulatory experienceRegulatory compliance knowledgeRisk management understandingBachelor's degreeMS Excel proficiencyCustomer service skillsEnglishCommunication skillsLeadership skillsNegotiation skills

Required

Bachelor's degree in Business or related field and/or equivalent combination of experience; insurance or financial services industry preferred

Minimum 5-10 years prior experience working with TPAs in the NAM regulatory space

Knowledge of regulatory best practices and state, province, and carrier requirements

Understanding of quality controls and risk management disciplines is a strong asset

Excellent communication skills (verbal, written, presentation) are needed to ensure sourcing strategies and tactical decisions are based on fact and data

Ability to influence and resolve complex regulatory issues

Strong organizational, customer service, leadership/influencing and negotiation skills

Proficiency in MS Excel (advanced formulas, pivot tables, MS Word, PowerPoint, and MS Outlook

English