Senior Claims Compliance Analyst

The Jonus Group•Chicago, IL

3d•$130,000 - $180,000

About The Position

Seeking a highly skilled and experienced Technical Claims Director, Property & Casualty to join a growing Claims Compliance and Quality Assurance team. This is a critical role for an accomplished insurance claims compliance professional or attorney with deep knowledge of insurance claims regulations, processes, and technology. You will play a pivotal role in safeguarding the organization from regulatory risks, ensuring compliance, and driving continuous improvement in claims handling practices.

Requirements

10+ years of experience in claims compliance, insurance regulation, or legal operations.
A degree in law, risk management, or a related field is required; J.D. is highly preferred.
Strong understanding of claims handling regulations, Medicare protocols, and market conduct standards.
Experience managing compliance in a 50-state claims environment across multiple lines of business.
Knowledge of Medicare Secondary Payer requirements and Section 111 reporting.
Strong research and policy writing skills.
Excellent collaboration, project management, and problem-solving abilities.
Experience with regulatory audit preparation and response.

Nice To Haves

Advanced insurance compliance certifications (e.g., CPCU, CIPP, CAMS, CRCM) are a plus.

Responsibilities

Manage and maintain a 50-state claims database.
Monitor legislation, DOI bulletins, court decisions, and statutory changes; manage backlog and implement targeted compliance training.
Develop and oversee controls related to Medicare, OFAC, Child Support Lien Network, and other federal protocols.
Collaborate with Claims Technical, Legal, and IT teams to design controls and workflows aligned with regulatory requirements.
Lead responses to regulatory inquiries and complaints.
Deliver training and provide legal support to internal teams and vendors.
Develop audit programs and dashboards to monitor compliance effectiveness.
Oversee and support technology-related compliance integrations.
Provide executive reporting, trends analysis, and regulatory insights.