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

10+ years of experience in claims compliance, insurance regulation, or legal operations
J.D. highly desired
Degree in law, risk management, or a related field; required
Advanced insurance compliance certifications a plus (CPCU, CIPP, CAMS, CRCM, or similar)
Scrum/PMP a plus but not required
Deep understanding of claims handling regulations, Medicare protocols, and market conduct standards
Experience with multiple lines of business in a 50-state claims environment
Knowledge of Medicare Secondary Payer requirements and Section 111 reporting
Strong research and policy writing skills
Excellent collaboration, project management, and problem-solving skills
Experience with regulatory audit preparation and response

401(k) with competitive company matching
Comprehensive health insurance, vision, dental and FSA plans (medical, limited purpose, and dependent care)
Company paid group term life, short
term disability and long-term disability coverage
24 Paid time off days plus 2 Hiscox days,10 paid holidays plus 1 paid floating holiday, and ability to purchase up to 5 PTO days
Paid parental leave
4-week paid sabbatical after every 5 years of service
Financial Adoption Assistance and Medical Travel Reimbursement Programs
Annual reimbursement up to $600 for health club membership or fees associated with any fitness program
Company paid subscription to Headspace to support employees’ mental health and wellbeing
202 4 Gold level recipient of Cigna’s Healthy Workforce Designation for having a best-in-class health and wellness program
Dynamic, creative and values -driven culture
Modern and open office spaces, complimentary drinks
Spirit of volunteerism, social responsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation

Senior Claims Compliance Analyst

Key skills