Compliance Analyst – Warranty

The Compliance Analyst will assist with the ongoing administration of compliance to support the sale of products offered by Fortegra and its partners. Assist in the research and evaluation of state insurance laws, regulations, and bulletins as well as lender requirements to implement appropriate procedures to ensure compliance in all states and jurisdictions.

Minimum Qualifications:

-Bachelor’s degree or equivalent experience.
-3-5 years’ experience in insurance, corporate compliance or legal field.

Primary Job Functions:

-Assist in the product consumer form/contract review process (inclusive of service contracts for automotive and consumer goods, home protection, limited warranties, and motor club programs).
-Provide recommendations to Compliance management for improvements and utilization.
-Proactively identify process/service improvement opportunities/efficiencies and make decisions or recommendations on the best course of action for new processes or procedures.
-Conduct research to advise management and affected departments on potential risks.
-Maintain database matrices of research for use by Compliance Department. Process national research projects, analyzing state legislature and regulatory insurance/service contract codes and constructing databases for easier readability.
-Quality Assurance (QA) Audits including but not limited to: provider and administrator licensing, consumer form implementation, and insurance policy issuance.
-Must be proficient in Microsoft Word, Excel and Outlook, with excellent document proofing skills.
-Other duties as assigned.

The above cited duties and responsibilities describe the general nature and level of work performed by people assigned to the job. They are not intended to be an exhaustive list of all the duties and responsibilities that an incumbent may be expected or asked to perform.

Requirements:

-Ability to work well both independently and in a team environment.
-Ability to perform varied tasks using computers, web-based programs and mainframe administrative systems.
-Ability to analyze issues, problem solve and recommend actionable responses.
-Ability to communicate and interact appropriately and professionally with internal/external customers, executive management and state departments -examiners in writing, in person and on the telephone.
-Self-motivated, ability to work independently and to preserve and protect proprietary and confidential information.
-Experience with vehicle/home/consumer service contracts and warranties a plus.

Senior Compliance Manager

This position requires an organized, detail oriented and efficient individual to support the development and oversight of the Warranty Compliance team and products. Duties include developing and reviewing policies and forms, assisting with product development and ensuring compliance throughout program onboarding and product distribution. Additional responsibilities may include training, marketing reviews, and regulatory change management.

Minimum Qualifications:

-Bachelor’s degree or equivalent experience.
-7-10 years’ of experience in insurance, specifically service contract/warranty compliance.
-Completion of Professional Designation is a plus i.e. CPCU, ACP, ARC and/or AINS.
-Experience in supervision of compliance, regulatory analyst or specialist roles.

Primary Job Functions:

-Develop product consumer forms and contracts, inclusive of service contracts for auto and consumer goods, home protection, limited warranties and motor club programs.
-Oversight of forms and rate filings with State Insurance Departments, direct contact with these departments may be required.
-Assist with product development.
-Monitor state insurance department bulletins for regulatory changes and updates; communicate such changes to underwriting teams, independent agents and brokers.
-Interpret and apply information from state insurance statutes and provide guidance to underwriters, licensing and other teams.
-Manage workflow process for all Smart Auto Care, Consumer, Home, Wireless and Auto TPA forms and programs.
-Responsible for the coordination, preparation and distribution of bulletin notifications as required.
-Generally assist the compliance team to ensure completion of projects within the projected target dates.
-Assist and manage internal audits to ensure compliance throughout the product onboarding and sales process.
-Supervise Regulatory &/or Compliance Analyst.
-Special projects as assigned by EVP, VP, &/or Director of Compliance.

The above cited duties and responsibilities describe the general nature and level of work performed by people assigned to the job. They are not intended to be an exhaustive list of all the duties and responsibilities that an incumbent may be expected or asked to perform.

Requirements:

-Deep understanding of limited warranties, service contracts and motor club products.
-Effective communication and writing skills, including grammatical usage, persuasive copy and style.
-Self-motivated, with the ability to work both independently and with a team.
-Ability to analyze issues, problem solve and recommend actionable responses.
-Ability to communicate and interact professionally with internal and external customers, including executive management.
-Ability to conduct legislative, regulatory and statutory research to ensure product and licensing compliance with state requirements.

Compliance Analyst

Job Summary: The Compliance Analyst position is an important component of Canal’s Legal Team and is responsible for assisting with the development and implementation of insurance policies, forms and other related documents, and answering compliance questions. The position plays a key role in updating and changing the policy forms portfolio. This position reports to the Vice President, General Counsel & Corporate Secretary and is a full-time position.

Major Accountabilities:

Review and provide analysis of state insurance department bulletins and circulars, ISO circulars, PCI Bulletins, and other related material to determine applicability.
Monitor, interpret, and track pending legislation that may impact Canal’s business, under attorney guidance.
Perform regulatory research involving state and federal laws, case law and other outside materials and effectively explain findings, under attorney and Senior Compliance guidance.
Assist in the coordination of activities pertinent to both new and modified products including researching, reviewing and filing new policy forms, rules and rates.
Track and maintain policy portfolio compliance with applicable state and federal regulations.
Assist in the development of compliance documentation and reference materials. Maintain such documentation as required.
Assist with the automation of new products and audit of output.
Communicate appropriate compliance-related information internally and externally and act as resource on compliance questions.
Perform compliance audits, as assigned, and report on findings including a proposed plan of action to correct non-compliance.
Perform other duties as assigned by Management.

Qualifications:

Education/Training Requirements: Bachelor’s degree in Law, Finance, Business Administration or a related field is preferred. However, candidates with some college education coupled with substantial relevant work experience in regulatory compliance, particular in the insurance or transportation industry, will also be considered.

Experience/Specialized Skills:

Special Considerations: Minimum three years of experience in regulatory compliance preferred, preferably in the insurance or transportation industry. Excellent analytical, organizational, writing and communication skills. Ability to interpret complex legal documents and regulatory guidelines. Proficient computer skills (word processing, spreadsheets, databases, reporting) required.

Physical Requirements: Constant use of vision, hearing, and communication (oral and written/in-person and via telephone). Frequent concentration, standing, walking, handling, reaching, and grasping. Occasional bending, kneeling and lifting (up to 25 lbs.) Heavy use of computer and office equipment.

Travel/Hours of Service: Occasional travel required. Periodic work outside of standard business hours or on weekends may be required.

Corporate Compliance Director (Primarily Office)

Provides compliance strategy for multiple insurance companies within the organization. This position will take a leading role in the corporate and operational compliance program(s) and in developing a coordinated and cohesive approach to operational compliance across multiple lines of insurance, different underwriting companies, operating systems, and various locations across the country. In addition, this position will be responsible for providing substantive legal advice to internal clients in a wide variety of legal areas.

Primary Accountabilities

• Creates a collaborative, performance-driven work environment by facilitating and fostering trust, transparency, and inclusion. Works with team members to set clear goals, provide feedback, perform performance assessments, and support on-going development.
• Leads with influence and expertise. Actively contributes to division or department leadership team. Communicates and supports organization mission, vision, values, policies, and practices.
• Leads a team that provides compliance and regulatory support for complex strategic regulatory and business processes.
• Reviews and evaluates corporate and operational compliance programs within the direct channel, identifying risks and developing operational compliance processes across emerging lines of business.
• Monitors, measures and reports on compliance program effectiveness and trends.
• Advocates before state Departments of Insurance and other regulatory agencies as needed to facilitate business initiatives while meeting legal and regulatory requirements.
• Serve as the subject matter expert on insurance regulatory requirements for various lines of business.

Physical Requirements
• Work that primarily involves sitting/standing.

Working Conditions
• Not applicable.

Specialized Knowledge and Skills Requirements

Demonstrated experience providing customer-driven solutions, support or service.
Demonstrated ability to foster innovation and initiate new ideas, methods and solutions.
Demonstrated leadership experience in a compliance or related discipline.
Demonstrated experience communicating technical information and complex ideas.
Demonstrated experience planning, managing, and/or leading complex projects or initiatives.
Solid knowledge and understanding of internal controls process and tools including Sarbanes Oxley (SOX) compliance.
Demonstrated effective leadership skills.
Education/Licenses/Designation

Juris Doctor (JD) strongly preferred.
Travel Requirements

This position requires travel up to 10% of the time.
Additional Information:

Offer to selected candidate will be made contingent on the results of applicable background checks.
Offer to selected candidate is contingent on signing a non-disclosure agreement for proprietary information, trade secrets, and inventions.
Our policy restricts consideration of applicants needing employment sponsorship (visa) to specialty occupations. Sponsorship will not be considered for this position.
Internal candidates are encouraged to apply regardless of location and will be considered based upon the needs of the role. You will be expected to work a minimum of 16 days a month at our NHQ in Madison.
We encourage you to apply even if you do not meet all of the requirements listed above. Skills can be used in many different ways, and your life and professional experience may be relevant beyond what a list of requirements will capture. We encourage those who are passionate about what we do to apply!

We provide benefits that support your physical, emotional, and financial wellbeing. You will have access to comprehensive medical, dental, vision and wellbeing benefits that enable you to take care of your health. We also offer a competitive 401(k) contribution, a pension plan, an annual incentive, 9 paid holidays and a paid time off program (23 days accrued annually for full-time employees). In addition, our student loan repayment program and paid-family leave are available to support our employees and their families. Interns and contingent workers are not eligible for American Family Insurance Group benefits.

We are an equal opportunity employer. It is our policy to comply with all applicable federal, state and local laws pertaining to non-discrimination, non-harassment and equal opportunity. We also consider qualified applicants with criminal histories, consistent with applicable federal, state and local law.

Annual Salary: Position Compensation Range: $144,000.00 – $245,000.00 Yearly

Regulatory Reporting Specialist

The Regulatory Reporting Specialist ensures the completion of the Property and Casualty Statistical reporting and other assigned data reports to the jurisdiction requesting the report or statistical agent used by the company. This role requires you to be in the office 3 days a week.

Branch of Medical Benefits Chief (GS-0991-15)

The Branch of Medical Benefits (BMB) is responsible for medical bill processing and ancillary medical benefits related activities for claimants who have accepted conditions and have claims for medical benefits (including working with providers on payment problems).

The Medical Bill Processing Unit (MBPU) oversees the medical bill processing systems, transactions, and coding necessary to assure prompt and accurate payment for approved medical and pharmacy benefits and works with OWCP’s Division of Administration and Operations (DAO), the Central Bill Processing (CBP) and Pharmacy Bill Processing (PBP) contractors to develop and implement appropriate bill payment codes, procedures, and resolutions to related bill payment issues.

The Medical Benefits Adjudication Units (MBAU), also known as the National District Office (Medical Benefits), provides medical benefits adjudication and decisions regarding requests for initial, ongoing, and increased home health care and all other ancillary or other medical benefits (such as Durable Medical Equipment, medical travel reimbursement, and medical transplant decisions). They also adjudicate recommended decisions specific to most negative decisions and for pharmacy, and medical benefits exception requests when payment for specific pharmacy medications or medical treatments have been denied by the bill processing contractors and/or DAO medical staff, or treatments are not in our Treatment Suites. Medical Benefits Examiners are responsible for collecting and weighing letters of medical necessity and supporting evidence and issuing determinations regarding the compensability of these services under DEEOIC Policies, Regulations and Statutes.

Annual Salary: $143,746 – $191,900 per year depending on the location

Compliance Specialist

OVERVIEW OF POSITION: The Compliance Specialist is responsible for creating and filing healthcare insurance policies as well as ensuring that Delta Dental of Illinois and its subsidiaries remain in compliance with state and federal laws, regulations, and guidelines.

DUTIES & RESPONSIBILITIES:

Insurance Product Filing
• Review and edit insurance policies, certificates, and schedules, to ensure compliance with all state and federal regulatory requirements.
• Complete SERFF/HIOS rate and form filings, including QHP filings, according to state and federal standards and handling of all state objections to filings.
• Research and document SERFF filing procedures to keep informed of any changes.
• Maintain an accurate database regarding current status of filings.
• Ability to work with State DOI officials and Exchange officials, as necessary, to resolve issues.

Regulatory and Healthcare Compliance
• Research federal and state laws and regulations.
• File TPA, SOS, and other annual license applications and renewals timely.
• Support the implementation and monitoring of the compliance program.
• Provide support and guidance to internal staff regarding compliance with laws and regulations.
• Assist with the development of educational materials on compliance topics for internal staff.
• Assist with the development of policies and procedures to ensure compliance with laws and regulations.
• Supports the Compliance Officer in investigating, reviewing, and tracking incidents involving Fraud, Privacy, and other non-compliance.
• Assists with Security Questionnaires, cybersecurity testing and training, and annual security audits.
• Assists the Compliance Officer with annual DDPA audits.
• Assists with responding to subpoenas, record requests, subrogations, and regulatory complaints.
• Perform other job-related duties as assigned.
• Maintain regular and punctual attendance.
• Access EPHI following the current guidelines as established at the company-wide and department levels.

EXPERIENCE & QUALIFICATIONS:
• 4-year college degree (or equivalent work experience)
• 5 years of experience with SERFF/HIOS filings for products both On-Exchange and Off-Exchange
• Experience in compliance, preferably within an insurance company
• Knowledge of state and federal requirements (e.g., required forms) related to product, rate and form filings
• Experience with legal research, technical, and business writing
• Knowledge of accident and health insurance
• Detail-oriented with excellent organizational and analytical skills
• Advanced skills in Microsoft Office applications
PREFERRED QUALIFICATIONS:
• Experience with healthcare privacy and security
• Experience with cybersecurity testing and training
• Experience with incident response and investigations for compliance, privacy, fraud, and/or security
• Experience with a Medicare compliance program
• Audit/Monitoring experience

*This position is based in our Naperville, Illinois office with flexibility to work from home as described in the Workplace Flexibility policy.

Annual Salary: $58,000-73,000; depends on relevant experience

Sr. Claims Representative

The Sr. Claims Representative plays a crucial role in assisting the Claims & Beneficiary Services team as it pertains to complex claims processing. Responsibilities include analyzing and communicating complex coverage issues, developing timely evaluations and effective strategies to resolve these complex claims most efficiently, and ensuring the highest level of service and communication to internal (staff) and external (members) stakeholders. This role will be the subject matter expert on documentation surrounding death benefit payments, which include but are not limited to trusts, wills, divorce settlements powers of attorney and estates. The position requires a highly knowledgeable and experienced professional with excellent communication and interpersonal skills, who thrives in a collaborative environment with mission-driven colleagues.

Annual Salary: Salary based on experience and location.

VP of Compliance

VP of Compliance (Personal Residential Insurance)

T.J. Jerger MGA, LLC. is growing and we are in search of an experienced VP of Compliance to join our team!

The VP of Compliance helps the organizations manage risks and avoid lawsuits by ensuring business operations are performed in compliance with state and federal laws.

Who are we?

Started in 2006, TJ Jerger is the Managing General Agency for American Traditions Insurance Company, the largest writer of manufactured home insurance in Florida. T.J. Jerger and ATIC are part of the Jerger family of companies.

Why work with us?

We are a family-oriented organization committed to providing competitive compensation and benefit packages to our employees including:

Medical, Dental, Vision, starting day 1 of employment
Multiple plans to choose from in order to fit your needs
401k plan available with 100% match up to 4% with immediate vesting
Generous PTO and paid holiday schedule
1 day of paid volunteer time off per year
Onsite workout facility
Casual dress code (work appropriate)

What will you be doing?

The Compliance Vice President coordinates, performs and/or oversees all state policy and rate filing activities as well as statistical data reporting and ensures company’s compliance with government regulations. Responsible for monitoring state policy form and rate regulations, ISO filing changes and communicating with business partners/units to recommend and implement procedural changes across the organization to ensure policy, rate fling and statistical data reporting activities comply with changing requirements.
Leads the strategy development, design, analysis and successful execution of the Personal Residential Insurance products. Has strong understanding of all components of the property products – including rate, rule, coverage, and underwriting.
Able to actively represent the team from a property product leadership perspective. Works with Personal Lines Insurance stakeholders to recommend and establish property product strategies for state initiatives.
Monitors the effectiveness and performance of the personal lines portfolio to identify growth and profitability opportunities in the product.
Close interaction with multiple teams / areas such as state teams, underwriting, claims, sales & marketing to drive premium production and profitability.
Analyzes and understands the impact of recommended product strategies, standards, actions and decisions as they impact agents, business centers and consumers.
Supports the implementation of product introductions / changes by working with state regulatory bodies.
Monitors property product performance/results in coordination with actuarial, loss analytics and performance analytic teams.

Ideal Candidate will possess:

Bachelor’s degree in Law, Business Administration, or Finance
5+ years prior experience in risk management or compliance roles
Compliance certification preferred
Superior attention to detail in order to identify and correct risky practices
Must be a strong communicator and capable of expressing oneself clearly both speaking and in writing
Possess a collaborative personality and be open to suggestions from team members
Exemplify strong knowledge of industry protocols and best practices
Excellent analytical skills and ability to accurately interpret complex documents and policies
Strong time management and organizational skills and able to meet deadlines
Should have a strong moral code and sense of ethics

T.J. Jerger MGA is an equal opportunity employer. All aspects of employment including the decision to hire, promote, discipline, or discharge, will be based on merit, competence, performance, and business needs. We do not discriminate on the basis of race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, veteran status, or any other status protected under federal, state, or local law.

Compliance & Product Specialist III

Summary: Under general supervision and with independent judgment supports the company’s mission of maintaining regulatory compliance by acting as the regulatory liaison for internal stakeholders and external partners, and is responsible for personal lines and commercial lines filings of the company’s rates, rules and forms with state departments of insurance, by performing the following duties:

Essential Duties and Responsibilities:
1. Acts as regulatory liaison for internal stakeholders, including management, and external partners, including: a. Offers expert guidance and technical knowledge using strong analytical skills to influence decisions made due to changes in the regulatory environment b. Identifies and evaluates alternatives to achieve and maintain compliance while meeting business goals and objectives c. Manages market conduct exams and other audit activities d. May handle larger and more complex filings and other projects e. Collaborates with external legal counsel as needed f. Builds and maintains solid relationships with stakeholders, management, external partners and state regulators

2. Promotes compliance with federal and state insurance statutes and regulations, including: a. Researches state specific filing requirements relating to insurance product initiatives b. Conducts research and evaluates state and federal regulatory developments to maintain a continuous course of compliance and identify and analyze compliance exposure and trends c. Monitors and reviews industry bulletins, ISO Circulars, NCCI Circulars, Independent Bureau Circulars, AAIS Bulletins, and trade publications. d. Monitors and advises key stakeholders of new updates to Statutory Requirements for cancellations and non-renewals. e. Performs audits to ensure systems are generating the state insurance regulators approved products

3. Manages Financial and Statistical Data Call Reporting, including: a. Prepares and submits routine financial data calls, statistical data calls, and regulatory calls/surveys on a timely basis b. Maintains a detailed inventory of compulsory financial and statistical data calls and regulatory surveys. c. Defines appropriate action for new reporting tasks. d. Collaborates with internal and external stakeholders to ensure effective reporting processes.

4. Monitors geographic expansion and diversification, including: a. Maintains Certificate of Authority (COA) documentation. b. Identifies licensing and financial reporting requirements. c. Prepares and submits Uniform Certificate of Authority Application (UCAA) filings and amendments. d. Prepares and submits Articles of Incorporation and By-Laws filings and amendments e. Prepares and submits Biographical Affidavits filings and amendments

5. Participates in product development, including: a. Ensures all new or amended rates, rules and forms comply with jurisdictional requirements b. Maintains a strong understanding of ISO, NCCI, and AAIS coverage forms, rules and rating plans, c. Maintains policy form number assignment records by line of business and assigns new numbers as new forms or products are created d. Assists in making necessary changes to filed products, systems or processes due to industry bulletins, ISO Circulars, NCCI Circulars, Independent Bureau Circulars, AAIS Bulletins, and trade publications. e. Assists in development and presentation of rules, rates and forms

6. Prepares and submits both proprietary and rating organizations filings to state insurance regulators to implement rate, rule and policy form revisions, including: a. Monitors the availability of rates, rules and forms by underwriting company and jurisdiction b. Coordinates activities and ensures timely submission of state or bureau loss costs, rule and form adoptions c. Handles large and complex state filings d. Creates memos and exhibits necessary for the submission of state filings. e. Coordinates and/or participates in meetings to review filing recommendations and status f. Works with stakeholders to develop responses to state regulators objections g. Uses submission portals: System for Electronic Rates & Forms Filing (SERFF) and Florida Insurance Regulation Filing System (IFRS). h. Maintains accurate and timely filing history i. Implements changes in rating manual pages and posting to Company intranet

7. Serves as a contributing member of project teams: a. Manages multiple regulatory/statute driven projects, using project management standards b. Coordinates and collaborates work efforts with key stakeholders, including IT, actuary, underwriting, product, and departments of insurance. c. Maintains effective communication throughout project life cycle while developing and presenting information to key stakeholders. d. Creates business requirements

8. Performs other duties as assigned.

Education/Experience: Bachelor’s degree (B.A.) from four-year college or university and two to four years of related experience and/or training; or equivalent combination of education and experience.