Senior Workers' Compensation Underwriting Compliance Specialist

92128, San Diego

 

PURPOSE OF THE JOB

The purpose of this job is to ensure that Workers' Compensation Underwriting (WCU) compliance programs are utilized appropriately to manage operational and compliance risks within the line of business. This position exists to ensure all regulatory and compliance requirements are met for the applicable jurisdictions/states.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Participates in the development and implementation of the WCU Compliance Program.

  • Assists with designing and ensuring compliance policies and procedures are followed throughout WCU.
  • Collaborates with professionals from different branches to verify Workers' Compensation Underwriting compliance requirements are being followed.
  • Retrieves and completes any reporting requirements specific to work comp underwriting.
  • Ensures internal controls are properly implemented and followed by WCU personnel.

Serves as WCU Compliance Subject Matter Expert on compliance related matters.

  • Researches WCU requirements and provides periodic updates on emerging compliance changes. Communicates to appropriate teams and formulates plans to make necessary changes.
  • Determines the impact of compliance changes on the WCU line of business.
  • Proposes modifications to existing programs to reflect needed modifications for upcoming compliance changes and ensures implementation.
  • Participates in cross-functional/cross-business initiatives, as needed.
  • Develops content for compliance related topics and delivers training to employees.

Performs audits on financial and procedural claims and recommends quality improvement measures.

  • Conducts financial and procedural audits based on various sampling methods.
  • Documents and trends audit findings.
  • Recommends quality improvement measures based on findings.
  • Meets with WCU Management team on a regular basis to discuss audit findings and recommendations.

SUPERVISORY RESPONSIBILITIES

This role does not have supervisory responsibilities.

EDUCATION AND EXPERIENCE

Bachelor's degree from four-year college or university preferred with a major or emphasis in Business Administration, Management, or related field. Minimum 5 years of related underwriting and/or compliance experience and/or training; or equivalent combination of education and experience.

CERTIFICATES, LICENSES, REGISTRATIONS

Chartered Property and Casualty (CPCU) certification preferred.

KNOWLEDGE AND SKILLS

Working knowledge of Workers' Compensation insurance industry in an underwriter role. Knows requirements for NCCI, WCIRB, and other specific State reports such as WCIS or DWC's. This position requires motivation, creativity, and ability to understand many areas of expertise. Ability to communicate professionally with all levels of management. Excellent verbal communication skills are necessary to produce and deliver quality training programs. Advanced understanding of Workers' Compensation Underwriting principles and application. Excellent time management and organizational skills. Requires a high level of attention to detail. Team oriented and a sense of urgency for execution. Ability to effectively present information to top management, and/or public groups. Ability to define problems, collect data, establish facts, and draw valid conclusions. Knowledge of compliance and auditing. Experience working with a property and casualty insurance company preferred. Ability to quickly understand and apply policies and procedures. Ability to research and interpret regulations and laws and disseminate information. Ability to multitask, organize, and prioritize work to meet deadlines. Ability to work with limited supervision. Intermediate to advanced level in Word, Excel, and PowerPoint.

PHYSICAL REQUIREMENTS

Office environment – no specific or unusual physical or environmental demands and employees are regularly required to sit, walk, stand, talk, and hear.

WORK ENVIRONMENT

This position operates in an office environment and requires the frequent use of a computer, telephone, copier, and other standard office equipment.