Contract Compliance Specialist II

BlueCross BlueShield of South Carolina•Columbia, SC

4d•Onsite

About The Position

The Contract Compliance Specialist II researches and interprets insurance laws and regulations related to division product form filings, prepares formal filings, and obtains approval from state insurance departments. The role communicates the impact of insurance bulletins, circulars, directives, and federal opinions to appropriate departments and supports compliance with applicable requirements. This role reviews, revises, drafts, and negotiates marketing, reinsurance, administrative, and other contract language. It identifies contractual deficiencies, recommends revisions, and coordinates legal review when needed. The specialist also prepares and maintains regulatory reports and corporate documents; maintains and troubleshoots policy and certificate issuance systems; manages complaint intake and distribution; and develops and maintains procedure manuals. The position is full time and onsite at 4101 Percival Road, Columbia, South Carolina. It reports to the Compliance Manager. The work environment is a typical office environment.

Requirements

Bachelor's degree, or an equivalent combination of four years of job-related work experience or an associate degree and two years of job-related work experience.
Five years of insurance experience, including at least four years in insurance compliance and insurance research.
Strong knowledge of insurance statutes and regulations and ERISA.
Strong written and verbal communication skills.
Microsoft Office proficiency.

Nice To Haves

Bachelor's degree in Business Administration or a related field.
Five years of experience in insurance compliance and insurance research.
Ability to work under minimal supervision.

Responsibilities

Research insurance statutes, regulations, and bulletins related to policy form filings; prepare formal contract filings and obtain insurance department approval.
Conduct preliminary research on state and federal requirements for new market opportunities and advise management of potential problem areas involving emerging opportunities and current core products.
Review, revise, and assist in drafting marketing, reinsurance, and administrative agreements; identify contractual deficiencies and recommend revisions.
Coordinate contract reviews with Companion's legal staff when necessary.
Prepare, maintain, and file reports and corporate documents required by state insurance departments and federal agencies for core products.
Maintain and operate policy and certificate issuance systems; design and program paragraph logic and codes for benefit selections and state variables; troubleshoot systems to maintain uninterrupted operation.
Communicate the impact of insurance department bulletins and federal opinions to the Compliance Manager and specialty product staff, and prepare responses when required.
Distribute summaries of relevant insurance department bulletins, circulars, directives, and federal opinions and directives to appropriate company personnel, and clarify technical interpretations.
Receive, log, and distribute insurance department and consumer complaints concerning core products for response and follow-up, ensuring timely responses.
Develop, update, and maintain procedure manuals to support job performance and timeliness.
Research state insurance statutes, regulations, bulletins, and NAIC models as requested by the Compliance Manager, Companion's legal department, and specialty product staff.
Review, revise, and negotiate contract language to mitigate risk and align with business objectives.
Manage contract negotiations from initial drafting through execution, collaborating with internal stakeholders and external parties.
Use contract lifecycle management platforms to manage contract creation, routing, approvals, execution, storage, and ongoing compliance.