Business Adherence Strategy, Claims - Remote

Overview

The claims department has an immediate opening for someone who can demonstrate the WCF values to join their team in a Business Adherence Strategy, Claims role. This is a full-time, exempt position and can be fully remote.

In Short

• Monitor accuracy, acceptance, and changes related to NCCI, WCIRB, and other 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 or market conduct exams.
• Stay current on all workers' compensation and other commercial claims law and regulation changes.
• Keep leadership informed of business-adherence related developments in a timely manner.

Requirements

• 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 bureau, 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.
• Action and results-oriented, with ability to operate at both a strategic and operational level.

Benefits

• Medical, Dental, and Vision insurance.
• Company paid life insurance.
• 401K with a generous 6% employer match.
• Employee Assistance Program.
• Time off to volunteer.
• 4 weeks of vacation in the first year.