Senior Claims Compliance Analyst

1 day ago

Chicago, Illinois, United States The Jonus Group Full time $130,000 - $180,000 per year

Job Description
Technical Claims Director, Property & Casualty
Job Summary
Seeking a highly skilled and experienced
Technical Claims Director, Property & Casualty
to join a growing Claims Compliance and Quality Assurance team. This is a critical role for an accomplished insurance claims compliance professional or attorney with deep knowledge of insurance claims regulations, processes, and technology. You will play a pivotal role in safeguarding the organization from regulatory risks, ensuring compliance, and driving continuous improvement in claims handling practices.

Compensation Package

  • Salary Range: $130,000 - $180,000 per year (based on experience and qualifications).

  • Benefits Include:

  • 401(k) with competitive company matching.

Responsibilities
As the Technical Claims Director, you will:

  • Manage and maintain a 50-state claims database.
  • Monitor legislation, DOI bulletins, court decisions, and statutory changes; manage backlog and implement targeted compliance training.
  • Develop and oversee controls related to Medicare, OFAC, Child Support Lien Network, and other federal protocols.
  • Collaborate with Claims Technical, Legal, and IT teams to design controls and workflows aligned with regulatory requirements.
  • Lead responses to regulatory inquiries and complaints.
  • Deliver training and provide legal support to internal teams and vendors.
  • Develop audit programs and dashboards to monitor compliance effectiveness.
  • Oversee and support technology-related compliance integrations.
  • Provide executive reporting, trends analysis, and regulatory insights.

Qualifications/Requirements

  • 10+ years of experience in claims compliance, insurance regulation, or legal operations.
  • A degree in law, risk management, or a related field is required; J.D. is highly preferred.
  • Advanced insurance compliance certifications (e.g., CPCU, CIPP, CAMS, CRCM) are a plus.
  • Strong understanding of claims handling regulations, Medicare protocols, and market conduct standards.
  • Experience managing compliance in a 50-state claims environment across multiple lines of business.
  • Knowledge of Medicare Secondary Payer requirements and Section 111 reporting.
  • Strong research and policy writing skills.
  • Excellent collaboration, project management, and problem-solving abilities.
  • Experience with regulatory audit preparation and response.

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