Claims Compliance And Quality Assurance Manager
Build a brilliant future with Hiscox
This position is hybrid and requires work in office a minimum of two (2) days per week. Position can be based at our following hub office locations :
- Atlanta, GA
- Chicago, IL
- Manhattan, NY
- Scottsdale, AZ
- West Hartford, CT
The US Claims Compliance and Quality Assurance team at Hiscox is a growing group of professionals with operational and technical experience. The team serves as a claims technical resource, as well as provides assistance and expertise across Hiscox by identifying and promoting claims best practices and facilitating required improvements. We foster consistency, calibration, and continuous improvement in the handling of Hiscox claims. Our team is quite diverse, and you will be able to demonstrate that you can flex your work and delivery style to accommodate different stakeholders.
You'll play a critical role in safeguarding our organization from regulatory risk. This is a high-impact role suited for an experienced insurance claims compliance professional or attorney, with deep knowledge of insurance claims regulations, processes, and technology. This role is ideal for someone who can translate risk into actionable strategy and build sustainable compliance practices as Hiscox USA grows.
Key Responsibilities
Manage and maintain 50-state claims databaseMonitor legislation, DOI bulletins, court reporters / decisions, and statutory changes; manage backlog and implement targeted compliance trainingDevelop and own controls related to Medicare, OFAC, Child Support Lien Network, and other federal protocolsPartner with Claims Technical, US Legal, and IT to design controls and workflows aligned with regulatory requirementsLead US Claims response to regulatory inquiries and complaintsDeliver training and legal support to internal teams and vendorsDevelop audit programs and dashboards to monitor compliance effectivenessOversee / support technology-related compliance integrationsProvide executive reporting, trends analysis, and regulatory insightsQualifications
10+ years of experience in claims compliance, insurance regulation, or legal operationsJ.D. strongly preferred, advanced insurance compliance certification a plusDeep understanding of claims handling regulations, Medicare protocols, and market conduct standardsExperience with multiple lines of business in a 50-state claims environmentKnowledge of Medicare Secondary Payer requirements and Section 111 reportingStrong research and policy writing skillsExcellent collaboration, project management, and problem-solving skillsExperience with regulatory audit preparation and responseCompensation : $120,000$155,000 based on experience. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.
About Hiscox US
Hiscox USA was established in 2006 to focus primarily on the needs of small and middle market commercial clients, via both the broker and direct distribution channels and is today the fastest-growing business unit within the Hiscox Group. Today, Hiscox USA has a talent force of about 420 employees mostly operating out of several major cities - New York, Atlanta, Chicago, West Hartford, and Scottsdale. Hiscox USA offers a broad portfolio of commercial products, including technology, cyber & data risk, multiple professional liability lines, media, entertainment, management liability, crime, kidnap & ransom, commercial property and terrorism.
What We Offer
401(k) with competitive company matchingComprehensive 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 coverage24 Paid time off days plus 2 Hiscox days, 10 paid holidays plus 1 paid floating holiday, and ability to purchase up to 5 PTO daysPaid parental leave4-week paid sabbatical after every 5 years of serviceFinancial Adoption Assistance and Medical Travel Reimbursement ProgramsAnnual reimbursement up to $600 for health club membership or fees associated with any fitness programCompany paid subscription to Headspace to support employees' mental health and wellbeing2024 Gold level recipient of Cigna's Healthy Workforce Designation for having a best-in-class health and wellness programDynamic, creative and values-driven cultureModern and open office spaces, complimentary drinksSpirit 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