Head of Claims Compliance, Employee Benefits (REMOTE)

Equitable•Syracuse, NY

2d•$160,000 - $200,000•Remote

About The Position

At Equitable, we help clients secure their financial well-being so they can pursue long and fulfilling lives- a mission we’ve honed since 1859. Equitable is looking for an experienced expert to join our team! The Head of Claims Compliance will oversee all aspects of our Employee Benefits (EB) Claims compliance framework. Reporting directly to the Head of Claims, this role is pivotal in ensuring compliance with regulatory and legal requirements in the administration of claims for our Employee Benefits product suite, with includes group dental, vision, life insurance, short and long term disability, statutory benefits, paid family leave, as well as supplemental health offerings, including accident, critical illness, hospital indemnity, and associated wellness benefits. This individual must be able to help deliver Employee Benefits’ “Powerfully Simple” vision, by supporting the Employee Benefits claims organization with a rigorous compliance framework.

Requirements

Bachelor’s degree
10+ years of experience in the Employee Benefits / Group Insurance industry
5+ years of direct experience with claims compliance in an Employee Benefits setting
Specific prior experience supporting one or more of the following products: group dental, vision, life insurance, short/long term disability, statutory benefits, paid family leave, and/or supplemental health offerings (accident, critical illness, hospital indemnity, and associated wellness benefits).

Nice To Haves

J.D. degree highly desired
Experience with FINEOS claims software a big plus
Strong understanding of compliance and internal controls
Excellent interpersonal and relationship building skills
Exceptional verbal and written communication skills

Responsibilities

Ensures all claims processes comply with relevant laws and regulations. Stays current regarding updated changes in legislation and adjusts advice accordingly.
Establishes and monitors key controls within the EB Claims organization, including SOX compliance. Partners with members of the EB Claims leadership team and internal control functions.
Ensures internal and external audit needs are well-coordinated and serves as the primary point of contact for internal and external claims-related audits, including market conduct.
Serves as the primary contact for items related to claims records management, to ensure full compliance with internal and external guidelines and regulations.
Collaborates on the EB Claims business continuity plan and works with internal and external vendor stakeholders to ensure plans are robust and revisited regularly.
Collaborates with enterprise privacy partners to ensure privacy outages are mitigated and coordinates prevention and control mechanisms related to claims data privacy.
Performs other duties as assigned.