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Munich Re America
Princeton, NJ, United States (on-site)
13 days ago
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Munich Re America
Princeton, New Jersey, United States (on-site)
13 days ago

Description

This role will work with the Head of Claims Compliance   to ensure that all claim staff are aware of and compliant with relevant state and federal laws and regulations as well as internal policies. The role also assists with Department of Insurance (DOI) related matters including claims licensing, inquiries, and market conduct responses. Additionally, the role will participate in TPA/MGA onboarding and compliance assessment, assist with Medicare reporting compliance, and work with our SIU vendor on various matters including anti-fraud training.

Responsibilities:
 
  • Reviews state insurance department bulletins for relevant updates and new/changed claim-related regulatory reporting requirements.
  • Curates and distributes bi-weekly regulation update newsletter to all Claims Department personnel.
  • Monitors due dates on Claims Compliance Tracking Database and ensures on time filing of data calls by claim staff and by TPA/MGA partners.
  • Directly handles assigned data call filings.
  • Conducts internal and external compliance audits.
  • Participates in Medicare reporting compliance management and training.
  • Assists with management of training and continuing education of claim staff as required to maintain state licenses.
  • Participates in our due diligence process for onboarding new TPA/MGA partners, and assists with compliance audits of TPA/MGA partners.
  • Works with and oversees SIU vendor to help ensure Claim Department and TPA/MGA compliance with state SIU/anti-fraud regulations.
  • Other similar projects and assignments as they arise.


Job Information

  • Job ID: 65781420
  • Workplace Type: On-Site
  • Location:
    Princeton, New Jersey, United States
  • Company Name For Job: Munich Re America
  • Position Title: Claims Compliance Specialist
  • Industry: Claims
  • Job Function: Claim Attorney
  • Job Type: Full-Time
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