Senior Program Claims Compliance Specialist (Los Angeles)

Argo Group International Holdings, Inc . and American National, US based specialty P&C companies, (together known as BP&C, Inc.) are wholly owned subsidiaries of Brookfield Wealth Solutions, Ltd. (BWS), a New York and Toronto-listed public company. BWS is a leading wealth solutions provider, focused on securing the financial futures of individuals and institutions through a range of wealth protection and retirement services, and tailored capital solutions.

Job Description

A Brief Overview

We are looking for a highly capable Program Claims Compliance Specialist to join our team and work from any of our US offices in Chicago, Los Angeles, New York City, Omaha, Richmond (VA), Rockwood (PA), or San Antonio. This individual will provide a wide range of administrative support to our Programs Department.

The role will work onsite (5 days per week) at one of our office locations : Los Angeles, CA, Omaha, NE, San Antonio, TX, Chicago, IL, New York City, NY, or Richmond, VA.

The primary duties and responsibilities of the role are :

• Under close supervision and guidance, works within narrowly defined limits and authority, assist our Program claims department with TPA compliance, program management and special projects with an impact on departmental results. This position will work closely with the Claim Account Managers and the Argo data team.
• Resolving issues that are generalized and typically not immediately evident, but typically not complex and within immediate job area.
• Partner in production of multiple reports for state compliance, TPA reporting and summary reporting.
• Perform TPA payment audits and provide audit assistance to TPA's request for documents and communications
• Liaison for DTS on data feed maintenance
• Schedule claim reviews, collect claim summaries and distribute
• Complete annual imprest reviews while evaluating imprest levels for appropriateness
• Partner with Claim Support in finding policy information / program TPA's with limited insured information
• Assist with audit reports and tracking
• Responsible for making independent adjustments or recommended enhancements in ad hoc special projects utilizing related business expertise
• Manage TPA due diligence process and response rate though payment and compliance audits, TPA questionnaires, E&O Policy review and state licensing reviews.
• Responsible for SharePoint site updating and IT onboarding for Claims adjuster access.
• Support new Program / TPA implementations
• Manage Cash calls and process, Replenishments, Claim Fees and escrow.
• Provision new TPA's and review existing access for Argo systems
• Maintain internal program and TPA adjuster directoriesand service instructions
• Provide support to MGA issue resolution
• Assist with EDI Processing, reporting, and resolution (preferred)

Core qualifications and requirements for this position include :

A minimum of six years in the insurance industry, preferably in a commercial claims department, or equivalent business environment is required, that includes :

Familiarity with EDI and ISO is preferred.

The base salary range provided below is for hires in those geographic areas only and will be commensurate with candidate experience. Pay ranges for candidates in other locations may differ based on the cost of labor in that location. In addition to base salary, all employees are eligible for an annual bonus based on company and individual performance as well as a generous benefits package.

About Working in Claims at Argo Group

PLEASE NOTE :

Applicants must be legally authorized to work in the United States. At this time, we are not able to sponsor or assume sponsorship of employment visas.

If you have a disability under the Americans with Disabilities Act or similar state or local law and you wish to discuss potential reasonable accommodations related to applying for employment with us, please contact our Benefits Department at 210-321-8400.

Notice to Recruitment Agencies :

Resumes submitted for this or any other position without prior authorization from Human Resources will be considered unsolicited. BWS and / or its affiliates will not be responsible for any fees associated with unsolicited submissions.

We are an Equal Opportunity Employer. We do not discriminate on the basis of age, ancestry, color, gender, gender expression, gender identity, genetic information, marital status, national origin or citizenship (including language use restrictions), denial of family and medical care leave, disability (mental and physical) , including HIV and AIDS, medical condition (including cancer and genetic characteristics), race, religious creed (including religious dress and grooming practices), sex (including pregnancy, child birth, breastfeeding, and medical conditions related to pregnancy, child birth or breastfeeding), sexual orientation, military or veteran status, or other status protected by laws or regulations in the locations where we operate. We do not tolerate discrimination or harassment based on any of these characteristics.

The collection of your personal information is subject to ourHR Privacy Notice

Benefits and Compensation

We offer a competitive compensation package, performance-based incentives, and a comprehensive benefits program-including health, dental, vision, 401(k) with company match, paid time off, and professional development opportunities.