Team Lead - Claims Compliance

We are actively seeking a Senior Claims Compliance, Team Lead to join our Claims team overseeing all regulatory compliance activities across multiple property and casualty lines of business. The ideal candidate will have a strong working knowledge of Claims P&C regulations with workers’ compensation experience. This role requires a proactive individual, who is comfortable working on multiple projects including interfacing with state regulatory authorities.

Job Responsibilities

• Review and assess, in partnership with Legal/Compliance and Claims lines of business leaders, all changes in state laws, statutes, regulations, and regulatory issues that may have an impact on Claims processes, procedure and workflows. 
• Take lead role in coordinating the implementation of regulatory and statutory changes, creation of new forms, and updating of workflows and manuals.  Ensure systems compliance with changes in statute, code and regulation.  Review and analyze claims data to identify trends, risks, and areas of non-compliance.
• Perform and/or lead others in regulatory compliance audits, evaluate findings, and make recommendations for changes in process, procedure, and workflow.  Oversee the implementation of Claims’ remediation plans, ensuring timely execution and proper documentation.
• Point of contact for all Claims compliance manners including managing RegEd notifications and ongoing compliance bulletins.  Manage Claims compliance notice repository (SharePoint).  Ensure Claims’ implementation of required regulatory changes. 
• Lead Claims involvement in market conduct examinations or other regulatory examinations for all lines of business.
• Ensure Claims Best Practices Manual, Authority Letters and all User manuals are current, regularly updated and appropriately stored.  Help coordinate training as required to ensure that Claims teams have required knowledge and expertise.
• Must also ensure appropriate action is taken in accordance with best practices to monitor claims compliance with state and federal regulation (including Medicare claims compliance) and implement procedures to avoid fines and penalties.  Collaborate with Legal/Compliance team to gather necessary information related to fines or penalties and help develop action plans for resolution.
• Take lead role in reviewing and responding to bureau criticisms, Department of Insurance, and other insurance complaints. Perform ad hoc Claims compliance research as needed.
• Prepare summary and trend reports for upper management to include compliance strengths and weaknesses, and actionable suggestions for improvement.
• Supervisory responsibilities include interviewing, hiring and training; planning, assigning and directing work; evaluating performance, rewarding and disciplining employees; addressing complaints and resolving problems.
• Other duties assigned at the direction of the Director of Claims and Manager.

Qualifications

• A strong working knowledge of Claims P&C regulatory requirements with experience in workers’ compensation required.
• Bachelor's degree required.
• Ability to assess processes to identify key areas of risk and implement resolution strategies in line with best practice.
• Ability to interact with multiple levels of staff and state regulatory authorities.
• Ability to work independently and in conjunction with others.
• Flexibility to work on multiple projects with the ability to meet tight deadlines.
• Strong analytical, research, organizational, critical thinking, and project management skills and the ability to apply them in a manner that protects the company’s interest while also providing the most amicable solution possible.
• Strong communication and documentation skills. 
• 4+ years of insurance Claims experience in all commercial lines with workers’ compensation experience required, J.D strongly preferred.

About Us

biBerk is where commercial insurance buyers can obtain coverage for their businesses from insurers of the Berkshire Hathaway group of Insurance Companies, one of the best capitalized insurance groups in the world. Our ultimate parent, Berkshire Hathaway Inc. (berkshirehathaway.com) is a holding company with diversified interests in a host of industries, including insurance, energy, transportation and manufacturing. Most policies issued through biBerk.com will be underwritten by Berkshire Hathaway Direct Insurance Company ("BHDIC"), which is an AM Best rated A++ insurer.

BHDIC is domiciled in Omaha, Nebraska. BHDIC and the team at biBerk are focused on helping small business owners quickly and easily buy affordable insurance directly from a financially strong insurance company they can trust.

Some highlights of our benefits are:

• Great work environment with growth opportunity
• Subsidized downtown parking (for in-office positions)
• Competitive compensation
• Generous amounts of vacation and sick time
• Closed on major holidays
• 401(k) with company match
• A fantastic healthcare package
• Tuition reimbursement after 6 months of employment
• Service recognition after 5 years of employment

In accordance with pay transparency laws and regulations, the following good faith compensation range estimate is being provided.  The salary range for this position is $95,000 to $135,000 per year.  Final compensation will be based on candidate qualifications, geographic location, and other considerations permitted by law.