AVP, Claims Compliance

AVP, Claims Compliance

The Opportunity: Own the compliance process for the Claims function and provide leadership and accountability to ensure proactive compliance with regulations; as well as, accurate and timely resolution of compliance related matters. Manage and support the compliance staff to ensure oversight is provided

• Location: Sun Prairie, WI

• Work Arrangement: Hybrid (2-3 days a week in the office)

• The salary range for this role is between $120,000 - $180,000

Your new role

• Responsible for understanding insurance regulations as they apply to claims handling

• Maintain awareness of current regulations by state; communicate new regulations related to claim handling throughout the claims organization

• Identify impact to claims organization of proposed and newly adopted regulations and work with operational leaders, technical leaders, and TPA to ensure compliance

• Represent QBE and coordinate with key business stakeholders on market conduct exams to ensure compliance with state Departments of Insurance

• Coordinate resources needed to support internal and external audits Coordinate with stakeholders to ensure that claim handling guidelines reflect current compliance requirements.

• Responsible for management check escheats, return checks, duplicate payment monitoring and other fiduciary controls as needed.

• Create, maintain, and analyze robust regulatory claim compliance metrics, executing corrective action plans as necessary

• Manage the Business Continuity planning for claims

• Coordinate internal compliance program with TPA compliance programs to ensure QBE standards of compliance are reflected in both retained and TPA claim handling.

• Responsible for the management of the Compliance budget and budget of the compliance staff

• Provide subject matter expertise knowledge on strategic projects

• Maintain and ensure the compliance library is updated with any required documentation

• Manage oversight of Medicare secondary payer claims

• Identify training needs related to compliance with claim handling practices; coordinate with L&D manager

• Responsible for ensuring Licensing controls are in place for all licensed adjusters; maintenance of license or new license requirements

• Establish a professional, polished company reputation by understanding, applying and upholding organizational values during outward-facing interactions and guiding team to ensure communications consistently align with company image

• Manage budgeted resources by anticipating expenditures, accurately forecasting resource needs/costs and properly accounting for expenses to meet requirements and achieve fiscal responsibility

Required Education

• Bachelor's Degree or equivalent combination of education and work experience

Required Experience

• 10+ years relevant experience

Preferred Competencies/Skills

• Influence Management

• Strategic planning and implementation

• Identify opportunities and implement strategies for synergy and integration

• Negotiate skillfully in tough situations with both internal and external groups

• Communicate information in a clear, well-organized, and professional manner

• Presentation Skills

• High degree of financial acumen and awareness of financial responsibility

• Analyze risks, benefits and opportunities to ensure organizational competitiveness and satisfaction of established long-range objectives

• Manage, influence and collaborate with people, including vendors, at different levels within the organization to accomplish a common goal

• Develop and use metrics to promote desired results

• Create and re-engineer processes to gain efficiency and effectiveness

• Provide vision; think creatively and innovatively

Preferred Knowledge

• Current and possible future policies, practices, trends, technology and information affecting his/her business and organization

• Advanced working knowledge of claims processes and best practices

• Comprehensive knowledge of project management, continuous improvement methodologies and application

Compensation Package: The salary range for this role is provided above. This is the national range for location(s) listed. The salary offer will be decided based on the role's complexity, its location, and the candidate's professional background, including their education and experience. Beyond the base salary, regular full-time and part-time employees will also be eligible for QBE's annual discretionary bonus plan based on business and individual performance.We encourage all candidates to apply, even if their salary expectations fall outside of this range, as we are committed to finding the right fit for our team.

QBE Benefits: We offer a range of benefits to help provide holistic support for your work life, whatever your circumstances. As a QBE employee you will have access to:

• Hybrid Working - a mix of working from home and in the office

• 22 weeks of paid leave for family growth, with 12 weeks available to all parents on a gender-equal basis

• Competitive 401(k) program with company match up to 8%

• Well-being program including holistic wellbeing coaching, gym membership, confidential counselling, financial and legal advice

• Tuition Reimbursement for professional certifications, and continuing education

• Employee Network and Community - QBE actively supports six Employee Networks, and many ways to give back to your community

To learn more, click here: Benefits | QBE US.

Why QBE? What if you could have a positive impact - at work and in the world?

At QBE, we're enabling a more resilient future - for our customers, communities, environment, and for our people. We're building momentum to achieve something significant and know our people are at the center of our success.

Our industry offers interesting and varied careers where you can help people to protect what matters most. As part of the QBE team, you'll get to spend every day working with people who are passionate, talented and kind. And our international scale means we're big enough for your ambitions, yet small enough for you to make a real impact.

Join us now, so you can be part of our success - and we can be part of yours!

https://www.linkedin.com/company/qbe-north-america/

Commitment to Diversity

QBE is committed to providing reasonable accommodation to, among others, individuals with disabilities and disabled veterans. If you need an accommodation because of a disability to search and apply for a career opportunity with QBE, please inform our Talent Acquisition team to let us know the nature of your accommodation request and your contact information.

Equal Employment Opportunity:

QBE provides equal employment opportunities to applicants and employees without regard to race; color; gender; gender identity; sexual orientation; religious practices and observances; national origin; pregnancy, childbirth, or related medical conditions; protected veteran status; or disability or any other legally protected status.

Supplementary information

Skills:

How to Apply:

To submit your application, click "Apply" and follow the step by step process.

Equal Employment Opportunity:

QBE is an equal opportunity employer and is required to comply with equal employment opportunity legislation in each jurisdiction it operates.