Health Insurance Senior Examiner

2 weeks ago


Jacksonville, Florida, United States STRATEGYGEN CO Full time
Job Title: Health Insurance Senior Examiner

STRATEGYGEN CO is seeking a highly skilled Health Insurance Senior Examiner to join our team. As a key member of our team, you will be responsible for evaluating health insurance issuers' compliance with state and federal laws and regulations.

Key Responsibilities:
  • Conduct market conduct activities, including onsite and desk audits, compliance and form filing reviews, market conduct examinations, and regulatory investigations.
  • Collaborate with project team members to develop and execute assigned market conduct activities.
  • Collect and analyze issuer records, files, and data to evaluate compliance with state and federal laws and regulations.
  • Document findings and prepare workpapers and other deliverables for supervisory review.
  • Prepare and submit draft reports, exhibits, and supporting documentation.
Requirements:
  • Bachelor's degree from an accredited college/university, plus 5 years of professional experience.
  • Significant experience in the health insurance sector, specifically related to healthcare compliance, healthcare regulations, healthcare auditing, or fraud investigation.
  • At least three (3) years of progressive professional work experience as an insurance auditor, including conducting market conduct examinations and MPHAEA NQTL analysis audits.
  • Must hold the Certified Insurance Examiner (CIE) designation from the Insurance Regulatory Examiners Society, as well as the Market Conduct Management (MCM) designation.
Preferred Skills:
  • Extensive knowledge of state and federal laws and regulations pertaining to the Affordable Care Act (ACA), Mental Health Parity and Addiction Equity Act (MPHAEA), and No Surprises Act (NSA).
  • Strong project management, organizational, communication, and writing skills.
  • Excellent interpersonal skills, with the ability to build strong working relationships.
  • High-level attention to detail.
  • Proficiency with MS Outlook, Excel, Word, Adobe, PowerPoint, and TeamMate Plus software.

We offer a competitive compensation package, a generous benefits package, flexible schedules, and a collaborative work environment. If you are a motivated and experienced professional looking for a new challenge, please submit your application.



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