Specialist, Contract Compliance II

BlueCross BlueShield of South Carolina • Columbia, SC

4d • Onsite

About The Position

Researches and interprets insurance laws pertaining to division products form filings and obtains approval from the various state insurance departments. Communicates impact of insurance bulletins, circulars, and directives to appropriate departments and ensures compliance with all laws and regulations.

Requirements

• Bachelor's Degree or 4 years job related work experience or Associate's and 2 years job related work experience
• 5 years insurance experience, 4 of which must be in insurance compliance and insurance research.
• Strong knowledge of insurance statutes and regulations and ERISA.
• Strong written and verbal communication skills.
• Microsoft Office.

Nice To Haves

• 5 years experience in insurance compliance and insurance research.
• Ability to work under minimal supervision.

Responsibilities

• Researches insurance statutes, regulations, and bulletins for policy form filings.
• Prepares formal contract filings and secures insurance department approval.
• Performs preliminary research on state and federal requirements pertaining to new market opportunities.
• Advises management of potential problem areas pertaining to emerging opportunities and current core products.
• Reviews, revises, and assists in drafting marketing, reinsurance, and administrative agreements.
• Identifies contractual deficiencies in written agreements and recommends appropriate revision.
• Coordinates the review of all contracts with Companion's legal staff, if necessary.
• Prepares, maintains, and files reports and corporate documents that pertain to core products and required by various state insurance departments and federal agencies.
• Maintains and operates policy and certificate issue systems.
• Designs and programs paragraph logic and codes to ensure proper benefit selections and state variables print correctly.
• Troubleshoots the systems to ensure policy and certificate systems remain uninterrupted.
• Communicates impact of insurance department bulletins and federal opinions to compliance manager and specialty product staff, and prepares response when required.
• Communicates the compliance department's summary of pertinent insurance department bulletins, circulars, and directives and all federal opinions and directives to appropriate company personnel.
• Provides clarification regarding technical interpretations.
• Receives, logs, and distributes complaints (insurance department and consumer) pertaining to core products for response and follow up to ensure timely response.
• Develops, updates, and maintains procedure manuals to ensure maximum job performance and timeliness.
• Researches state insurance statutes, regulations, bulletins, and NAIC models as requested by 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 to achieve mutually beneficial agreements.
• Utilize CLM platforms to manage contract creation, routing, approvals, execution, storage, and ongoing compliance throughout the contract lifecycle.

Benefits

• Subsidized health plans, dental and vision coverage
• 401k retirement savings plan with company match
• Life Insurance
• Paid Time Off (PTO)
• On-site cafeterias and fitness centers in major locations
• Education Assistance
• Service Recognition
• National discounts to movies, theaters, zoos, theme parks and more

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level