Senior Claims Compliance Analyst
Location
Georgia + 5 moreAll locations: Georgia, Illinois, Connecticut, Arizona, Massachusetts, New York
Posted
18 days ago
Salary
$90K - $140K / year
Bachelor Degree9 yrs expEnglishClaims Database ManagementCompliance TrainingInsurance RegulationsMedicare ProtocolsProject Management Tools
Job Description
Job Type:
Permanent
Build a brilliant future with Hiscox
Please note that this position is hybrid and requires work in
office
a minimum of two (2) days per week. Position can be based at our following hub office locations:
Atlanta, GA
Boston, MA
Chicago, IL
Manhattan, NY
Scottsdale, AZ
West Hartford, CT
The US Claims Compliance and Quality Assurance team at Hiscox is a growing group of professionals with operational and technical experience. The team serves as a claims technical resource, as well as
provides
assistance
and
expertise
across Hiscox by
identifying
and promoting claims best practices and
facilitating
required improvements. We foster consistency, calibration, and continuous improvement in the handling of Hiscox claims. Our team is quite diverse, and you will be able to
demonstrate
that you can flex your work and delivery style to accommodate different stakeholders.
You’ll play a critical role in safeguarding our organization from regulatory risk. This is a high-impact role suited for an experienced insurance claims compliance professional or attorney, with deep knowledge of insurance claims regulations, processes, and technology. This role is ideal for someone who can translate risk into actionable strategy and build sustainable compliance practices as Hiscox USA grows.
Key Responsibilities
Manage and maintain 50-state claims database
Monitor legislation, DOI bulletins, court reporters/decisions, and statutory changes; manage backlog and implement targeted compliance training
Develop and own controls related to Medicare, OFAC, Child Support Lien Network, and other federal protocols
Partner with Claims Technical, US Legal, and IT to design controls and workflows aligned with regulatory requirements
Qualifications
10+ years of experience in claims compliance, insurance regulation, or legal operations
J.D. highly desired
Degree in law, risk management, or a related field; required
Advanced insurance compliance certifications a plus (CPCU, CIPP, CAMS, CRCM, or similar) Scrum/PMP a plus but not required
Deep understanding of claims handling regulations, Medicare protocols, and market conduct standards
Experience with multiple lines of business in a 50-state claims environment
Knowledge of Medicare Secondary Payer requirements and Section 111 reporting
Strong research and policy writing skills
Excellent collaboration, project management, and problem-solving skills
Experience with regulatory audit preparation and response
Compensation:
$90,000–$140,000 based on experience
The actual salary for this position will be determined by
a number of
factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.
About Hiscox US
A
Hiscox USA was established in 2006 to focus primarily on the needs of small and middle market commercial clients, via both the broker and direct distribution channels and is today the fastest-growing business unit within the Hiscox Group.
Today, Hiscox USA has a talent force of about 420 employees mostly
operating
out of several major cities - New York, Atlanta, Chicago, West Hartford, and Scottsdale. Hiscox USA offers a broad portfolio of commercial products, including technology, cyber & data risk, multiple professional liability lines, media, entertainment, management liability, crime, kidnap & ransom, commercial
property
and terrorism.
What We Offer:
401(k) with competitive company matching
Comprehensive health insurance, vision, dental and FSA plans (medical, limited purpose, and dependent care)
Company paid group term life, short- term disability and long-term disability coverage
24 Paid time off days plus 2 Hiscox days,10 paid holidays plus 1 paid floating holiday, and ability to
purchase
up to 5 PTO days
Paid parental leave
4-week paid sabbatical after every 5 years of service
Financial Adoption Assistance and Medical Travel Reimbursement Programs
Annual
reimbursement
up to $600 for health club membership or fees associated with any fitness program
Company paid subscription to Headspace to support employees’ mental health and wellbeing
202
4
Gold level recipient of Cigna’s Healthy Workforce Designation for having a best-in-class health and wellness program
Dynamic,
creative
and
values
-driven culture
Modern and open office spaces, complimentary drinks
Spirit of volunteerism, social
responsibility
and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation
You can follow Hiscox on LinkedIn,
Glassdoor
and
Instagram (@
HiscoxInsurance).
#LI-AJ1
Work with amazing people and be part of a unique culture
Job Requirements
- Lead US Claims response to regulatory inquiries and complaints
- Deliver training and legal support to internal teams and vendors
- Develop audit programs and dashboards to monitor compliance effectiveness
- Oversee/support technology-related compliance integrations
- Provide executive reporting, trends analysis, and regulatory insights