Health Insurance Examiner

3 weeks ago


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

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

Key Responsibilities:
  • Collaborate with senior examiners to develop and execute market conduct activities
  • Collect and analyze issuers' records, files, and data to evaluate compliance
  • Document findings and prepare workpapers and deliverables for supervisory review
  • Assist with preparing draft reports, exhibits, and supporting documentation
  • Perform research and analysis of regulatory updates and guidance issued by CCIIO
  • Review and support the update of examination protocols
  • Serve as a subject matter expert and resource to other staff
Requirements:
  • Bachelor's degree from an accredited college plus 1-2 years of relevant experience
  • Significant experience in the health insurance sector, specifically related to healthcare compliance, healthcare regulations, healthcare auditing, or fraud investigation
  • Must hold the Market Conduct Management (MCM) designation from the Insurance Regulatory Examiners Society
  • Accredited Insurance Examiner (AIE) designation - a plus
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
  • Intermediate level computer skills, including MS Outlook, Excel, Word, Adobe, PowerPoint, and general knowledge of database programs and spreadsheet options


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