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Senior Claims Compliance Counsel
Refer job# TDVY170518
 
Senior Claims Compliance Counsel The candidate will assist the Claims Compliance team with claims legal and regulatory matters. Will identify and understand the potential legal risks arising from claims legal and regulatory matters and assist the Manager, Director, or Senior Director of Claims Compliance with addressing such risks and providing practical, solution-based advice to clients. Develop and review legal agreements that include but are not limited to managing general agent agreements, claims service agreements, independent adjuster agreements, and third-party administrator agreements. In conjunction with the Manager, Director, or Senior Director of Claims Compliance, provide advice and guidance on compliance issues, including but not limited to, adjuster licensing and training, vendor agreements, and market conduct and financial exams in multiple states. Promote and enhance strong relationships with customers and channel partners.

The candidate should have Bachelor's degree. Must have Juris Doctorate Law Degree from an ABA-accredited law school and active membership in at least one state Bar. RN or other medical degree preferred. Insurance certifications or designations are a plus. Broad regulatory and contract advice experience required. Broad experience across multiple Claims lines of business (including Worker's Compensation, Casualty/GL, Property/Marine and Professional Liability) required. Must have 10+ years of Claims experience or an equivalent combination of education and experience. Experience with P&C insurance Medicare/Medicaid compliance (including Section 111 reporting, lien negotiation and MSAs) preferred. Experience with contract negotiation and drafting required. Experience with broader Claims compliance obligations (including Fair Claims Handling and adjuster licensing) is strongly preferred. Experience with project/program management preferred. Experience with GuideWire's Claim Center is desired.
 
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