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The Claims Regulatory Senior Consultant works closely with our Claim Regulatory Compliance Director, our Law Department, and our Internal Investigations/Audit teams to provide support services to our Claim Organization regarding claim handling compliance with regulations applicable for Workers' Compensation and Auto General Liability.
JOB DESCRIPTION:
Essential Duties & Responsibilities
Performs a combination of duties in accordance with departmental guidelines:
- Acts as the subject matter expert for the Claim organization to ensure understanding and compliance with applicable state, federal and other regulatory requirements. Identifies research, analyzes, and understands existing, new, and revised regulatory requirements that are applicable to claim handling for all lines of business.
- Develops and maintains a library of regulatory and compliance information and resources to assist the Claim Regulatory Compliance team and Claim professionals that is easily accessible and up to date. Monitors and stays current on proposed / pending changes in law and regulations, industry activity and trends that impact the Claim organization.
- Provides subject matter expertise and direction to the Claim Quality Technical Directors and field Claim teams regarding regulatory requirements. Communicates new requirements and changes to existing requirements that trigger corresponding changes to business processes, procedures, or behaviors in the Claim organization. Partners with the lines of business to ensure necessary changes are enacted promptly and accurately.
- Partners with the Law department and the Internal Investigation/Audit team to manage and coordinate responses to regulator and consumer inquiries. Reviews responses to determine if any follow-up actions are necessary to modify processes, procedures, or behaviors in the Claim organization. Partners with the lines of business to ensure necessary changes are enacted promptly and accurately.
- Assists the EDI Data Management team and the Compliance Data Governance team in understanding regulations related to data gathering and reporting.
- Acts as subject matter expert to assist in regulatory compliance related training for all Claim lines of business.
May perform additional duties as assigned.
Reporting Relationship
Typically, Director or above
Skills, Knowledge & Abilities
- A solid understanding of the insurance industry, its practices, and operations.
- In-depth knowledge and application of regulatory requirements applicable to the Claim organization, particularly related to workers compensation claims.
- Excellent interpersonal, verbal, and written communication skills, with the ability to effectively interact with internal and external business partners.
- Advanced analytical and problem-solving skills with ability to manage and prioritize multiple projects.
- Ability to weigh alternatives, select an appropriate course of action and act with a sense of urgency.
- Excellent organizational skills including ability to prioritize and coordinate multiple tasks. Exceptional attention to detail.
- Ability to work in a collaborative environment.
- Committed to continuous learning culture.
- Strong computer skills including Microsoft Office Suite and other business-related software systems.
Education & Experience
- Bachelor's degree or equivalent experience required.
- Typically, a minimum eight years related work experience, with significant exposure to insurance claim regulations.
- Experience working with Departments of Insurance and other regulatory bodies preferred.
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CNA is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact [email protected] .
