Claims Regulatory Compliance Manager at Amerisure Insurance

Job description

Amerisure creates exceptional value for its partners, policyholders, and employees. As a property and casualty insurance company, Amerisure’s promise to our partner agencies and policyholders begins with a comprehensive line of insurance products designed to protect businesses, as well as the health and safety of every employee. With an A.M. Best “A” (Excellent) rating, Amerisure serves mid-sized commercial enterprises focused in construction, manufacturing and healthcare. Ranked as one of the top 100 Property & Casualty companies in the United States, we proudly manage nearly $1 Billion of Direct Written Premium and maintain $1.21 billion in surplus. Amerisure is currently recruiting for a Claims Regulatory Compliance Manager that can do a 2-day hybrid approach onsite in one of our offices. The ideal candidate will also possess the following skill set. Summary Statement The Regulatory Compliance Manager is responsible for ensuring that Claims department complies with all applicable laws, regulations, and industry standards. This role involves monitoring changes in regulations, implementing policies to meet compliance requirements, conducting audits within the claims department(s), and serving as a liaison with regulatory authorities. Essential Tasks/Major Duties Manage, train, provide performance feedback and assign duties of direct reports to ensure productivity, efficiency, and effectiveness. Develop, review, and update internal claims processing policies and procedures to ensure compliance with regulatory standards. Collaborate with other departments to integrate compliance considerations into company-wide policies. Develop and implement strategic plans for area of responsibility. Serve as the claims department’s main point of contact with regulatory bodies and coordinate the people and necessary information to respond to state audits and other regulatory inquiries. Maintain accurate and comprehensive records as required by laws and regulations or company needs and ensure that information is readily available for review as necessary. Design, implement, and monitor regulatory enterprise risk management solutions with input from other department leaders, Internal Audit, Office of Legal Counsel, and others as applicable. Manage the department’s quality assurance process and provide analysis and updates based on findings and trends. Prepare and submit regulatory reports, such as data calls, requests for information, internal controls testing etc., as required which may include coordinating with Financial Services, Internal Audit, Office of Legal Counsel, or external vendors as appropriate. Develop, lead, and implement training programs for claims staff to enhance their understanding of Medicare compliance requirements, emphasizing accurate documentation and reporting. Remain perpetually informed about changes to all relevant laws and regulations and, in a timely manner, update the department and/or specific stakeholders as to the impact of those changes, as appropriate. Knowledge, Skills & Abilities Bachelor’s degree in business, law, or a related field preferred. Advanced degrees or certifications in compliance preferred. 5 years of commercial insurance experience. 2 years of leadership experience. Proven experience in regulatory compliance within the insurance industry, with a focus on claims compliance. Strong understanding of insurance laws, regulations, and industry best practices. Intermediate proficiency with Microsoft Office Suite. Ability to think strategically with supporting analytical and problem-solving skills, including the ability to deal with ambiguity. Demonstrated successful ability to build positive relationships and partnerships within department and across the organization. Excellent verbal and written communication skills with the ability to interact with internal and external customers. Ability to travel overnight up to 15%. #LI-BR1 Just as we are committed to creating exceptional value for our Partners For Success® agencies and policyholders, Amerisure also remains committed to being an employer of choice. We reinforce this commitment by adhering to an Employee Value Proposition that, in part, is provided through a competitive total rewards package. This package includes competitive base pay, performance-based incentive pay, comprehensive health and welfare benefits, a 401(k) savings plan with profit sharing, and generous paid time off programs. We also offer flexible work arrangements to promote work-life balance. Recognized as one of the Best and Brightest® Companies to Work For in the Nation and one of Business Insurance magazine’s Best Places to Work in Insurance , we provide a workplace that fosters excellence and professional growth. If you are looking for a collaborative and rewarding career, Amerisure is looking for you. Amerisure Mutual Insurance Company is an Equal Employment Opportunity employer. Amerisure provides equal employment opportunities to all employees and applicants without regard to race, color, religion, sex (to include sexual orientation and gender identity), national origin, age, disability, genetic information, veteran status, or any other protected characteristic under applicable federal, state, or local laws. Amerisure complies with all applicable laws governing nondiscrimination in employment in all locations where the company operates. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training. Amerisure prohibits harassment or discrimination of any kind and is committed to maintaining a workplace free from unlawful harassment or discrimination. Amerisure prohibits retaliation against anyone who reports discrimination, participates in an investigation, or opposes unlawful practices. Any improper interference with an employee’s ability to perform their job duties may result in disciplinary action, up to and including termination.

Requirements

Must-haves

Amerisure is currently recruiting for a Claims Regulatory Compliance Manager that can do a 2-day hybrid approach onsite in one of our offices. The ideal candidate will also possess the following skill set.
Summary Statement
Essential Tasks/Major Duties
Manage, train, provide performance feedback and assign duties of direct reports to ensure productivity, efficiency, and effectiveness.
Develop, review, and update internal claims processing policies and procedures to ensure compliance with regulatory standards.
Collaborate with other departments to integrate compliance considerations into company-wide policies.
Develop and implement strategic plans for area of responsibility.
Serve as the claims department’s main point of contact with regulatory bodies and coordinate the people and necessary information to respond to state audits and other regulatory inquiries.
Maintain accurate and comprehensive records as required by laws and regulations or company needs and ensure that information is readily available for review as necessary.
Design, implement, and monitor regulatory enterprise risk management solutions with input from other department leaders, Internal Audit, Office of Legal Counsel, and others as applicable.
Manage the department’s quality assurance process and provide analysis and updates based on findings and trends.
Develop, lead, and implement training programs for claims staff to enhance their understanding of Medicare compliance requirements, emphasizing accurate documentation and reporting.
Remain perpetually informed about changes to all relevant laws and regulations and, in a timely manner, update the department and/or specific stakeholders as to the impact of those changes, as appropriate.
Knowledge, Skills & Abilities
5 years of commercial insurance experience.
2 years of leadership experience.
Proven experience in regulatory compliance within the insurance industry, with a focus on claims compliance.
Strong understanding of insurance laws, regulations, and industry best practices.
Intermediate proficiency with Microsoft Office Suite.
Ability to think strategically with supporting analytical and problem-solving skills, including the ability to deal with ambiguity.
Demonstrated successful ability to build positive relationships and partnerships within department and across the organization.
Excellent verbal and written communication skills with the ability to interact with internal and external customers.
Ability to travel overnight up to 15%.

Nice-to-haves

Bachelor’s degree in business, law, or a related field preferred. Advanced degrees or certifications in compliance preferred.

Application prep

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Platform: workday
Effort: long

Benefits

Benefits detected in the listing.

401(K)

Paid Time Off