Health Insurance Senior Examiner

4 months ago

Jacksonville, United States STRATEGYGEN CO Full time
Job DescriptionJob DescriptionStrategyGen is seeking experienced Health Insurance Senior Examiners to join our team The Senior Examiner is responsible for conducting compliance reviews, insurance market conduct examinations, audits and regulatory investigations under the Affordable Care Act (ACA) regulation. Additionally, one or more of these position(s) will serve as lead examiner(s) for successful execution of the Mental Health Parity and Addiction Equity Act (MHPAEA) non-quantitative treatment limitation (NQTL) analysis audits. 

Candidates for this position must have experience in performing and leading market conduct examinations and MPHAEA NQTL analysis audits, hold the Certified Insurance Examiner (CIE) designation and have in-depth knowledge of standards and processes in the NAIC’s Market Regulation Handbook. The ability to work under minimal supervision while delivering high-quality products on time and on budget is vital for this position. As such, the candidate should possess good time management, prioritization, communication and interpersonal skills, and the ability to work cohesively with the team and follow the lead of the Examiner-in-Charge and Program Director/Project Officer. 

StrategyGen offers competitive compensation, flexible schedules, a collaborative work environment and highly qualified leadership to assist our team. This is a remote full-time position, however there may be periodic limited travel involved. 

Responsibilities/Duties: 

  • Develop and prioritize the review schedule and levels of effort to ensure timely completion of exams/audits/reviews
  • Perform research and analysis of regulatory updates and guidance issued by CCIIO to ensure that testing is current and consistent with the NAIC Market Regulation Handbook and federal regulations
  • As lead examiner, assign, oversee and direct MPHAEA NQTL analysis audit team in performing audits, investigations, reviews and market conduct examinations
  • Document the research and analysis that has been completed and provide supporting documentation for Findings, specifically documenting how operational areas are not in compliance or where errors are identified
  • Use audit software (TeamMate Plus) by completing all required sections and all work within the appropriate work areas
  • Prepare draft report and exhibits to summarize all Findings
  • Modify audit software to accurately reflect the report as issued after edits have been incorporated
  • Create and maintain project deliverables and reports to support contractual and regulatory compliance
  • Review and support the update of examination protocols when new regulations are released to ensure that they reflect the latest information 
  • Serve as a Subject Matter Expert, and as a resource and mentor for other staff
  • Perform other duties as assigned
Education & Experience: 

  • Bachelor's degree in a related field plus 5 years of professional experience 
  • At least three (3) years of progressive professional work experience as an insurance auditor, including conducting market conduct examinations and MPHAEA NQTL analysis audits and in a leadership or management role overseeing and conducting examinations, investigations and/or audits
  • Must hold the Certified Insurance Examiner (CIE) designation from the Insurance Regulatory Examiners Society
  • Market Conduct Management (MCM) insurance designation
  • In-depth knowledge of standards and processes in the NAIC’s Market Regulation Handbook
  • Intermediate level computer skills; MS Outlook, Internet Explorer, Excel, Word, Adobe, PowerPoint as well as general knowledge of data base programs and spreadsheet options
  • TeamMate Plus software experience desired 
Specific Knowledge & Skills: 

  • Extensive knowledge of Local, State, and Federal laws and regulations pertaining to the Affordable Care Act (ACA), health insurance, and/or healthcare services
  • Knowledge of health care laws and regulations (HIPAA, ERISA) a plus
  • Significant experience in the health insurance sector, specifically related to health care compliance, health care regulations, health care auditing, or fraud investigation
  • Strong project management, organizational, communication and writing skills, with the ability to change priorities quickly, handle multiple tasks simultaneously and meet deadlines
  • Excellent interpersonal skills, with the ability to build strong working relationships within the audit team and cross-functionally
  • Strong understanding and commitment to professional auditing standards
  • High-level attention to detail

  • Health Insurance Senior Examiner

    3 weeks ago

    Jacksonville, United States STRATEGYGEN CO Full time $90,000 - $115,000

    Job DescriptionJob DescriptionStrategyGen is seeking experienced Health Insurance Senior Examiner(s) to join our team! This is a full-time remote position, with limited travel. StrategyGen offers competitive compensation, a generous benefits package, flexible schedules, and a collaborative work environment.The Senior Examiner is responsible for performing...

  • Health Insurance Senior Examiner

    3 weeks ago

    Jacksonville, United States STRATEGYGEN CO Full time $90,000 - $115,000

    Job DescriptionJob DescriptionBenefits:401(k) matchingCompetitive salaryDental insuranceFlexible scheduleHealth insurancePaid time offTraining & developmentVision insurance StrategyGen is seeking experienced Health Insurance Senior Examiner(s) to join our team! This is a full-time remote position, with limited travel. StrategyGen offers competitive...

  • Health Insurance Senior Examiner

    4 months ago

    Jacksonville, United States STRATEGYGEN CO Full time

    Job DescriptionJob DescriptionStrategyGen is seeking experienced Health Insurance Senior Examiners to join our team! The Senior Examiner is responsible for conducting compliance reviews, insurance market conduct examinations, audits and regulatory investigations under the Affordable Care Act (ACA) regulation. Additionally, one or more of these position(s)...

  • Health Insurance Senior Examiner

    4 weeks ago

    Jacksonville, United States StrategyGen Co Full time

    StrategyGen is seeking experienced Health Insurance Senior Examiners to join our team! The Senior Examiner is responsible for conducting compliance reviews, insurance market conduct examinations, audits and regulatory investigations under the Affordable Care Act (ACA) regulation. Additionally, one or more of these position(s) will serve as lead examiner(s)...

  • Health Insurance Examiner

    4 weeks ago

    Jacksonville, United States STRATEGYGEN CO Full time $70,000 - $90,000

    Job DescriptionJob DescriptionStrategyGen is seeking experienced Health Insurance Examiner(s) to join our team! This is a full-time remote position, with limited travel. StrategyGen offers competitive compensation, a generous benefits package, flexible schedules, and a collaborative work environment. Job Summary The Health Insurance Examiner is responsible...

  • Health Insurance Examiner

    4 weeks ago

    Jacksonville, United States STRATEGYGEN CO Full time $70,000 - $90,000

    Job DescriptionJob DescriptionBenefits:401(k) matchingCompetitive salaryDental insuranceFlexible scheduleHealth insurancePaid time offTraining & developmentVision insurance StrategyGen is seeking experienced Health Insurance Examiner(s) to join our team! This is a full-time remote position, with limited travel. StrategyGen offers competitive compensation, a...

  • Health Insurance Examiner

    1 week ago

    Jacksonville, Florida, United States StrategyGen Co Full time

    Job SummaryWe are seeking an experienced Health Insurance Examiner to join our team at StrategyGen Co. As a key member of our team, you will be responsible for evaluating health insurance issuers' compliance with state and federal laws and regulations.ResponsibilitiesCollaborate with senior examiners to develop and execute market conduct activities,...

  • Building Plans Examiner Senior

    7 days ago

    Jacksonville, Florida, United States City of Jacksonville Full time

    Job Title: Building Plans Examiner SeniorJoin the City of Jacksonville's Planning and Development Department as a Building Plans Examiner Senior. This role is responsible for examining construction plans for residential, commercial, and industrial buildings to ensure compliance with applicable building codes.Key Responsibilities:Review and analyze...

  • Claims Examiner

    2 hours ago

    Jacksonville, Florida, United States Jobot Full time

    {"title": "Claims Examiner", "description": "Job SummaryWe are seeking an experienced Claims Examiner to join our dynamic team. As a Claims Examiner, you will play a crucial role in analyzing and resolving a variety of insurance claims.Key ResponsibilitiesEvaluate and investigate insurance claims promptly and accurately, ensuring all necessary documentation...

  • Claims Examiner

    7 days ago

    Jacksonville, Florida, United States Jobot Full time

    {"Job Title": "Claims Examiner", "Job Description": "Job SummaryWe are seeking an experienced Claims Examiner to join our dynamic team. As a Claims Examiner, you will play a crucial role in analyzing and resolving insurance claims. Your strong analytical skills, excellent negotiation skills, and high level of organization will enable you to manage complex...

  • Insurance Claims Examiner

    1 week ago

    Jacksonville, Illinois, United States Kelly Services, Inc. Full time

    About the OpportunityThis great job is a temporary to hire opportunity with a Top Health Insurance company. We are seeking a Claims Specialist to work with our team. As a Claims Specialist, you will be responsible for handling claims and providing excellent customer service to our clients.Key Responsibilities- Handle claims and resolve issues in a timely and...

  • Become a Licensed Health Insurance Agent with e-TeleQuote Insurance

    2 weeks ago

    Jacksonville, Florida, United States e-TeleQuote Insurance Full time

    About the Rolee-TeleQuote Insurance is seeking a highly motivated and sales-driven individual to join our team as a Licensed Health Insurance Agent. As a key member of our team, you will play a critical role in helping Medicare beneficiaries select a Medicare plan that best suits their healthcare and financial needs.Key ResponsibilitiesUtilize compliant...

  • Insurance Sales Representative

    2 weeks ago

    Jacksonville, Florida, United States American Senior Benefits Full time

    About American Senior BenefitsWe are a leading hybrid sales organization offering a unique opportunity in insurance sales. Our company proudly represents over 220 top carriers, providing a stable and secure environment for our agents.Our MissionWe are committed to helping our clients achieve their healthcare goals by providing exceptional service and...

  • AFC Examination Oversight Specialist

    3 weeks ago

    Jacksonville, Florida, United States Deutsche Bank Full time

    Job ID:R Full/Part-Time: Full-time Regular/Temporary: Regular Location: Jacksonville Position Overview Job Title AFC Examination Oversight Specialist Corporate Title Assistant Vice President Location Jacksonville, FL Overview Deutsche Bank benefits from a proficient and committed Anti Financial Crime (AFC) function, which plays a vital role in maintaining...

  • Insurance Business Development Specialist

    7 days ago

    Jacksonville, Florida, United States Brown & Brown Insurance Full time

    {"Job SummaryWe are seeking a highly motivated and detail-oriented Associate Broker to join our team at Brown & Brown Insurance. As a key member of our commercial lines team, you will be responsible for analyzing market research information, selling and renewing business, and developing creative strategies to produce new and renewal business.Key...

  • Insurance Advisor

    20 hours ago

    Jacksonville, Florida, United States American Senior Benefits Full time

    About American Senior BenefitsWe are a leading insurance marketing group in the country, backed by Integrity. Our mission is to put people back in the people business, focusing on building strong relationships with our clients and partners.Job SummaryWe are seeking a highly motivated and customer-focused Insurance Advisor to join our team. As an Insurance...

  • Records Examiner/Analyst

    7 days ago

    Jacksonville, Florida, United States FSA Federal Full time

    {"title": "Records Examiner/Analyst", "description": "Job SummaryFSA Federal is seeking a highly skilled Records Examiner/Analyst to support the Federal Bureau of Investigation (FBI) in its mission to protect the American people and uphold the Constitution of the United States.Key ResponsibilitiesReview and evaluate data and information from multiple sources...

  • Insurance Advisor

    2 hours ago

    Jacksonville, North Carolina, United States American Senior Benefits Full time

    About American Senior BenefitsWe are a leading provider of insurance solutions, backed by Integrity, the largest insurance marketing group in the country. Our mission is to empower our agent partners with the tools, training, and support they need to succeed in the industry.Job SummaryWe are seeking a highly motivated and customer-focused Insurance Advisor...

  • Insurance Advisor

    2 hours ago

    Jacksonville, Florida, United States American Senior Benefits Full time

    About American Senior BenefitsWe're a leading insurance marketing group in the country, backed by Integrity. Our philosophy is simple: putting people back in the people business. We believe in doing the right thing and building strong relationships with our clients and partners.Job SummaryWe're seeking a highly motivated and customer-focused Insurance...

  • Building Plans Examiner

    2 weeks ago

    Jacksonville, Florida, United States City of Jacksonville Full time

    Job DescriptionJob Summary:The City of Jacksonville is seeking a highly skilled Building Plans Examiner to join our team in the Planning and Development Department. As a Building Plans Examiner, you will be responsible for examining construction plans for residential, commercial, and industrial buildings to ensure compliance with applicable building...