Operations Compliance Specialist in Milwaukee, WI at National General Insurance

Date Posted: 6/16/2020

Job Snapshot

Job Description

Primary Purpose:

Responsible for implementing changes, quality audits, reporting and updating documentation in order to meet the Compliance requirements for Operations.

Essential Duties and Responsibilities:

Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time.

  • Interact with other key stakeholders with respect to implementing Law Review and state bulletins provided by Compliance including product updates, claims changes, fulfillment, and other Operations related items
  • Communicate any needed Compliance updates to the necessary Third-Party Administrators and audit to ensure items are implemented correctly
  • Complete Grievance reporting as needed per states’ requirements
  • Provide consistent quality audit monitoring for teams in Operations and TPAs on a monthly/quarterly basis including review of prompt pay, state grievance guidelines, and Explanation of Benefits
  • Work with Compliance manager to follow up on requirements based on feedback from Insurance Department Complaints
  • Compile information and work with the Compliance team and the TPAs to complete Market Conduct Exam requests
  • Analyze Operational reporting data to find trends, patterns, and irregularities in order to understand how changes impact operational performance at National General and our TPAs (Third Party Administrators)
  • Create/Maintain documentation and Standard Operating Procedures for all procedures/workflows within Operations with a review twice a year or more often if needed
  • Provide support to the corporate internal audit department for SOX and other financial audits as it relates to operational compliance issues

Minimum Skills and Competencies:

The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Bachelor Degree or in-lieu of degree equivalent education, training and work-related experience
  • 2+ years of experience working in the individual health or supplemental health insurance industry
  • Proficient in Microsoft Office (Word, Excel, Outlook, PowerPoint)
  • Must possess effective verbal and written communication skills
  • Experience facilitating or leading meetings/projects
  • Ability to provide feedback based on audit results
  • Must perform well in high-energy, dynamic and team-oriented environments
  • Ability to problem solve and make decisions independently
  • Effective organization and time management skills with the ability to work under pressure and adhere to departmental and state deadlines
  • High degree of independence, dependability, and motivation
  • Ability to make sound decisions that maintain compliance with state and company guidelines
  • Excellent interpersonal skills with the ability to establish working relationships with individuals at varying levels within the organization
  • Ability to make sound decisions that maintain compliance with state and company guidelines

Desired Skills:

  • Experience with National General Insurance programs for all states and lines of business
  • Experience with the claim-handling process
  • Experience in working with Third-Party Administrators

#LI-LR1

National General Holdings Corp. is an Equal Opportunity (EO) employer – Veterans/Disabled and other protected categories. All qualified applicants will receive consideration for employment regardless of any characteristic protected by law. Candidates must possess authorization to work in the United States, as it is not our practice to sponsor individuals for work visas.

In the event you need assistance or accommodation in completing your online application, please contact NGIC main office by phone at (336) 435-2000.

Job Requirements

About National General Holdings:

National General Holdings Corp. is headquartered in New York City. National General traces its roots to 1939, has a financial strength rating of A– (excellent) from A.M. Best, and provides personal and commercial automobile, homeowners, umbrella, recreational vehicle, motorcycle, supplemental health, and other niche insurance products. We are a specialty personal lines insurance holding company. Through our subsidiaries, we provide a variety of insurance products, including personal and commercial automobile, homeowners, umbrella, recreational vehicle, supplemental health, lender-placed and other niche insurance products.

National General is a fast paced, dynamic, and entrepreneurial organization. Our team members live by and exemplify what we call the 4Es. At National General, we are Energized, Engaged, Empowered, and we Execute every day in order to provide an exceptional experience for our customers! We are passionate about our organization and the value that we add every day. A successful candidate with National General will embody the 4Es. Our team is poised to outperform the competition. We are National General Insurance and with us you can be extraordinary! Come join our team!

Companies and Partners

Direct General Auto & Life, Personal Express Insurance, Century-National Insurance, ABC Insurance Agencies, NatGen Preferred, NatGen Premier, Seattle Specialty, National General Lender Services, ARS, RAC Insurance Partners, Mountain Valley Indemnity, New Jersey Skylands, Adirondack Insurance Exchange, VelaPoint, Quotit, HealthCompare, AHCP, NHIC, Healthcare Solutions Team, North Star Marketing, Euro Accident.

In addition to a phenomenal career opportunity, National General Insurance offers an excellent benefits package including:

• Paid Training
• Medical, Dental, Vision benefits
• Wellness Programs
• Life and Short/Long Term Disability Insurance
• 401k w/ Company Match
• Company Paid Holidays & Generous Time-off policy
• Employee Discount Program
• Career Advancement and Development Opportunities
• On-site Healthcare Clinic (Winston-Salem and Cleveland offices)
• On-site Fitness Center (Cleveland and Dallas offices)
• Subsidized parking (Cleveland office)

National General Holdings Corp. is an Equal Opportunity (EO) employer – Veterans/Disabled and other protected categories. All qualified applicants will receive consideration for employment regardless of any characteristic protected by law. Candidates must possess authorization to work in the United States, as it is not our practice to sponsor individuals for work visas.

In the event you need assistance or accommodation in completing your online application, please contact NGIC main office by phone at (336) 435-2000.