Senior Claims Compliance Analyst (FPA4)

State of Washington • Thurston County – Tumwater, WA

2d • Hybrid

About The Position

The Office of the Insurance Commissioner (OIC) seeks 2 qualified individuals for the Senior Claims Compliance Analyst (Functional Program Analyst 4) position. These roles are within the Consumer Protection Division and are based out of our Tumwater Office. The Office of the Insurance Commissioner is seeking 2 Senior Claims Compliance Analysts (FPA4) to serve as recognized subject matter experts in insurer claims handling practices and unfair trade practices investigations. In this highly visible role, you will lead independent reviews of the agency's most complex, high-profile, and technically challenging consumer complaints involving property and casualty insurance claims. You will analyze insurer conduct, evaluate compliance with state and federal insurance laws, and work directly with consumers, attorneys, insurance company leadership, legislators, and agency executives to resolve disputes and promote fair treatment of policyholders. These positions play a critical role in advancing the agency's mission to protect consumers, the public interest, and our state's economy through fair and efficient regulation of the insurance industry. This recruitment may be used to establish a qualified pool of candidates for Functional Program Analyst 4 (FPA 4) vacancies in the next sixty days. This is a Washington General Service position.

Requirements

• Seven (7) years of professional work experience. Experience should include substantive work involving insurance regulation, insurance compliance, market conduct oversight, policy review, regulatory affairs, claim handling, risk management, legal compliance or related field.
• Relevant experience may include roles such as claims adjuster, insurance compliance analyst, insurance examiner, market conduct examiner, Insurance regulatory analyst, risk management analyst or comparable positions at an insurance company, insurance agency, or at a municipal, state or federal regulatory agency.
• Intermediate-level skills and experience in Microsoft Outlook, Word, and Excel; and Basic PowerPoint.

Nice To Haves

• Two (2) or more years demonstrated professional level experience with licensure or compliance of regulated entities, including but not limited to financial analysis, audits or examinations, and/or inspection of technical documentation such as business contracts, policies, and agreements.
• Prior experience as a Functional Program Analyst 3 with the Washington Office of the Insurance Commissioner (OIC) performing licensing application reviews, financial analysis/exams, consumer complaint analysis, or comparable experience with the OIC; or comparable experience with another state’s department of insurance.
• Three (3) years of work experience producing work product that demonstrates scrupulous attention to detail and superior writing skills.
• Industry professional designations, such as, Accredited Financial Examiner (AFE), Chartered Property Casualty Underwriter (CPCU), Fellow Life Management Institute (FLMI), Certified Insurance Examiner (CIE), Accredited Insurance Examiner (AIE), Associate, Insurance Regulatory Compliance (AIRC), Associate Professional in Insurance Regulation (APIR), or Professional in Insurance Regulation (PIR).
• Fluent verbal communication skills in Spanish, Korean, Russian, Vietnamese, Mandarin, or Cantonese, with the ability to score “Advanced Mid skill level” on the oral proficiency assessment by the American Council for the Testing of Foreign Languages.

Responsibilities

• Investigate and analyze complex, high-priority consumer complaints involving insurance claims handling practices and alleged unfair trade practices.
• Conduct independent reviews of claim denials, settlement decisions, coverage determinations, and adjuster conduct to evaluate compliance with insurance laws and regulations.
• Research insurance policies, contracts, claims files, and insurer practices to identify potential violations and determine appropriate resolutions.
• Serve as a technical expert on insurer claims handling standards, unfair claims settlement practices, and insurance regulatory requirements.
• Collaborate with consumers, attorneys, insurance company representatives, and agency staff to resolve disputes and promote fair treatment of policyholders.
• Prepare comprehensive complaint analyses, regulatory findings, and recommendations for corrective or enforcement actions.
• Provide guidance and consultation to agency leadership and staff on complex claims-related and regulatory issues.
• Support investigations and enforcement activities involving unlawful, unfair, or inequitable insurance practices.
• Deliver training and technical assistance to agency staff on emerging claims handling, coverage, and compliance issues.
• Participate in special projects, process improvement initiatives, policy analysis, and cross-agency workgroups to strengthen consumer protection efforts.

Benefits

• Health, dental, vision, retirement, paid leave (vacation,sick, etc.) and much more!
• Supportive work environment: We value diversity, professional growth, and collaborative atmosphere.
• Wellness programs: Invest in your well-being with on-site resources and initiatives.
• Work-life balance: Flexible schedules with telework opportunities.
• Public service fulfillment: Contribute to a cause that matters and feel the satisfaction of serving the public good.
• Training & Development: Continuously learn and grow with tuition reimbursement, Public Service Loan Forgiveness,and other programs.
• Free parking (Tumwater) & Public transportation pass (Thurston County): Save on commuting costs.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed