American Family Insurance - Corporate Claims Compliance Advisor in Madison, Wisconsin

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Quick Stats:

Job ID:

R8854 Claims Compliance Advisor (Open)

Summary:

The Claims Compliance Advisor is responsible for the execution of the oversight programs for the Division. Manages departmental projects for adherence to process control, document and record control, as well as internal controls and compliance with company policies, procedures and practices. Collaborates with Operational Leadership to verify changes to claim handling practices, procedures and system changes will comply with compliance guidelines. Coordinates market conduct surveys, complaint handling and legal discovery process for the division to ensure compliance with regulatory standards.

Responsibilities:

Travel Requirements

  • This position requires travel up to 10% of the time.

Specialized Knowledge and Skills Requirements

  • Demonstrated experience providing customer-driven solutions, support or service

  • Demonstrated experience planning, managing, and/or leading complex projects or initiatives.

  • Solid knowledge and understanding of internal controls process and tools including Sarbanes Oxley (SOX) compliance.

  • Solid knowledge and understanding of the legal discovery process.

Additional Job Information:

Positions can be housed in Madison and/or Waukesha office. Solid Casualty background and strong written skills preferred.

These positions will focus on customer complaint handling. Candidates selected for an interview with the hiring manager will be asked to complete a written complaint handling skill assessment.

Job Description:

Primary Accountabilities

Implementation of Internal Control & Risk Assessment Analysis

  • Completes internal controls risk assessment and documentation processes for business processes that may impact multiple complimentary controls or are integrated or interdependent on other processes.

  • Facilitates the development of test plans for compound and complimentary internal controls in accordance with insurance regulations and corporate standards. Monitors the execution of test plans and development of process remediation’s where needed by process owners of divisional business processes and controls.

  • Documents and monitors implementation of process remediation’s and retesting when needed. Communicates the results of internal risk control assessments and process and system testing to department managers and divisional leadership.

  • Prepares necessary documentation, data, and obtains sign-offs regarding internal controls assessment results for the Internal Control Unit within established timeframes.

  • Collaborates with Internal Controls Unit of the Controller Division when developing and implementing divisional internal control processes and systems. Facilitates integration of Claims Internal Control programs with Corporate Internal Control programs.

  • Provides Internal Audit management organized documentation of risk assessment performed by the auditor.

Expert Resource

  • Serves as a resource to Claim Product, claim employees and leadership in their area of expertise relating to compliance issues.

  • Monitors trends in the industry and determines best practices to improve compliance. Represents the Company at industry meetings.

  • Interacts with other divisions in the exchange of information, reports, and special studies. Serve on various committees, and task forces, as assigned.

  • Assists the Quality Assurance area as it schedules, plans and conducts file reviews of pending and closed claims. Monitors Quality Assurance report and findings regarding the division`s performance with respect to compliance with policies, practices, and standards of work product.

Compliance Program Management

  • Collaborates with Legal to coordinate legal discovery and pre-litigation efforts for the division. Coordinates legal discovery work within the division.

  • Works with outside vendors such as the Insurance Service Organization (ISO), National Insurance Crime Bureau (NICB) to ensure compliance with insurance statutes.

  • Coordinates market conduct surveys for the division and partners with Internal Controls and Internal Audit to manage internal control standards for the division.

  • Facilitates the division`s compliance committee.

  • Facilitates state specific adjuster licensing requirements and compliance.

Complaint Program Management

  • Collaborates with Operations to coordinate written complaint responses for complainants, insurance departments and other regulatory agencies to ensure the complaint is completely answered, timely, grammatically correct, and formatted property.

  • Develops relationships with Insurance Department staff to ensure appropriate complaint responses and encourage open communication regarding inquiries and responses.

  • Collaborates with Consumer Affairs to develop Claims processes around investigations, responses and procedures.

  • Logs complaints to accurately identify trends, isolate issues that should be escalated to management and ensure all timelines are met to avoid adverse actions by insurance departments/regulators.

Project Management Services

  • Serves as project leader for complex divisional, cross-divisional and cross-departmental projects. Provides guidance with regard to project direction, project plans, implementation, and measurable results. Manages project risks, resources, timeline, and reporting.

  • Creates and implements change management plans in conjunction with divisional or cross-departmental projects.

  • Coordinates project resources from a variety of areas to manage project dependencies. Constructs and implements project roll-out plans for the division.

  • Acts as liaison with other divisions on necessary projects, ensuring effective integration and communication. Promotes collaboration and consensus in decision making on projects among a diverse group of people with differing attitudes and objectives.

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At American Family Insurance, we know how hard our customers and employees work to achieve their dreams. That’s why, for nearly 90 years, we’ve made it our mission to protect those dreams. It’s all part of who we are and who we’ll always be – innovative, caring, agile, trustworthy, transparent and passionate. We’re a strong, forward-looking company and a proven leader in our industry. And if you’re looking to make a difference, we’re looking for you.