Claims Compliance and Audit Specialist

Claims Compliance and Audit Specialist

Job Locations US-United States

Requisition ID

2024-17726

Category

Compliance

Position Type

Regular Full-Time

Overview

Responsible for executing quality and compliance assessments and / or engaging in regulatory management activities. Partners with key stakeholders to improve compliance with state laws and measures adherence to internal claims procedures.

Acts as a trusted advisor for the business. Delivers actionable reporting on time and meets compliance deadlines. Maintains a solid understanding of AmTrust's mission, vision, and values.

Upholds the standards of the AmTrust organization.

Responsibilities

Performs moderately complex scheduled assessments of key business processes, state requirements, and legal activities, under limited supervision.

• Performs target assessments of a designated process to identify key opportunities to improve operational efficiency, claim outcomes, and / or customer experience.
• Serves as an informal subject matter expert resource, assisting the business with quality, compliance, and legal questions related to process execution.
• Creates consumable reports and delivers assessment results to the appropriate level of leadership and applicable stakeholders.
• Analyzes and interprets data to monitor trends, identify root causes, and partners with the business to proactively isolate issues and support the development of measurable action plans.
• Conducts activities related to regulatory oversight such as market conduct exams, state licensing, consumer complaints, and data calls.
• Prioritizes tasks effectively, meeting assessment / project due dates, and identifies and escalates competing demands and / or dependencies.
• Acquires and applies a growing knowledge of the regulatory landscape to ensure proper compliance with laws and internal processes.
• Develops and maintains a strong understanding of QA methodologies, tools, and risk management principles.
• Keeps current with market trends and demands.
• Performs other duties as assigned.

Qualifications

• Bachelor's Degree in related field OR equivalent business experience.
• 5+ years of related claims experience, with recent background in a quality or compliance oversight role.
• Strong oral and written communication skills.
• Ability to evaluate, prioritize and make informed decisions to ensure timely and accurate completion of all assignments.
• Applicable claims, compliance, risk, and / or legal designations such as ARM, AIC, CRCMP, CLMP, ARC, CPCU, SCLA, or IRES designations desirable.

Preferred :

• 2 years experience in Commercial Product Lines.
• Expert communicator with demonstrated ability to translate information in a way that is easily understood by varying audiences;

mastering the art of business storytelling to drive action.

• Experience working with Departments of Insurance and other regulatory bodies.
• Proven experience in identifying trends through advanced data and analytics.
• Process improvement certifications (such as Six Sigma).

This job description is designed to provide a general overview of the requirements of the job and does not entail a comprehensive listing of all activities, duties, or responsibilities that will be required in this position.

AmTrust has the right to revise this job description at any time.

LI-REMOTE

What We Offer

AmTrust Financial Services offers a competitive compensation package and excellent career advancement opportunities. Our benefits include : Medical & Dental Plans, Life Insurance, including eligible spouses & children, Health Care Flexible Spending, Dependent Care, 401k Savings Plans, Paid Time Off.

AmTrust strives to create a diverse and inclusive culture where thoughts and ideas of all employees are appreciated and respected.

This concept encompasses but is not limited to human differences with regard to race, ethnicity, gender, sexual orientation, culture, religion or disabilities.

AmTrust values excellence and recognizes that by embracing the diverse backgrounds, skills, and perspectives of its workforce, it will sustain a competitive advantage and remain an employer of choice.

Diversity is a business imperative, enabling us to attract, retain and develop the best talent available. We see diversity as more than just policies and practices.

It is an integral part of who we are as a company, how we operate and how we see our future.

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