Compliance Analyst II

West Bend Insurance Company • West Bend, WI

2d • Hybrid

About The Position

Supports multi-state claims compliance by ensuring accurate, timely regulatory reporting, advising claims teams on requirements, and helping maintain adherence to state and federal guidelines. This position offers a hybrid work schedule. Candidates who are located within 50 miles of a West Bend office location will work a hybrid schedule for collaboration days, team meetings or other in-person events. The position can be based in West Bend, Madison or Appleton.

Requirements

• At least 2 years of experience adjusting claims or in claims support
• Working knowledge of Medicare compliance and/or workers’ compensation state reporting
• 3 years of data entry experience
• Working knowledge of medical, legal, and insurance terminology
• Strong attention to detail with solid analytical and organizational skills
• Ability to work independently, manage priorities, and solve problems
• Clear written and verbal communication skills, along with basic math skills
• Interpersonal skills, including the ability to provide training or guidance to others
• Basic proficiency in Microsoft Word and Excel

Nice To Haves

• Bachelor’s degree in Business, Insurance, or related field (or equivalent industry experience)
• Associate in General Insurance (AINS) designation
• Associate in Claims (AIC) designation

Responsibilities

• Independently manage claims reporting responsibilities across all assigned states and jurisdictions, ensuring required data is reported accurately and on time.
• Review policy and claims documentation, enter claim and payment data into reporting systems, and maintain diaries to support timely filings and follow-up activities.
• Review state reports for accuracy and compliance, correct errors promptly, and help resolve any inquiries, fines, or penalties that may arise.
• Serve as a point of contact for EDI-related issues.
• Provide technical guidance to claims representatives.
• Stay current on regulatory and industry changes through ongoing learning.
• Assist with job overviews and training.
• Analyze current workflows and recommend process improvements to increase efficiency and effectiveness.
• Consistently demonstrate strong customer service and adherence to audit guidelines.

Benefits

• Medical & Prescription Insurance
• Health Savings Account
• Dental Insurance
• Vision Insurance
• Short and Long Term Disability
• Flexible Spending Accounts
• Life and Accidental Death & Disability
• Accident and Critical Illness Insurance
• Employee Assistance Program
• 401(k) Plan with Company Match
• Pet Insurance
• Paid Time Off. Standard first year PTO is 17 days, pro-rated based on month of hire. Enhanced PTO may be available for experienced candidates
• Bonus eligible based on performance

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree