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Senior Claims Compliance Analyst

🇺🇸 United States

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$90,000 - $150,000

Senior Claims Compliance Analyst

from 🇺🇸 United States

$90,000 - $150,000

Job Type:

Permanent

Build a brilliant future with Hiscox
 

Please note that this position is hybridOR REMOTE. Hybrid expectations are inoffice a minimum of two (2) days per week. Position can be based at our following hub office locations: 

  • Atlanta, GA 

  • Boston, MA

  • Chicago, IL

  • Manhattan, NY

  • Scottsdale, AZ

  • West Hartford, CT

The US Claims Compliance and Quality Assurance team at Hiscox is a growing group of professionals with operational and technical experience. The team serves as a claims technical resource, as well asprovides assistance andexpertise across Hiscox byidentifying and promoting claims best practices andfacilitating required improvements. We foster consistency, calibration, and continuous improvement in the handling of Hiscox claims. Our team is quite diverse, and you will be able todemonstrate that you can flex your work and delivery style to accommodate different stakeholders. 

You’ll play a critical role in safeguarding our organization from regulatory risk. This is a high-impact role suited for an experienced insurance claims compliance professional or attorney, with deep knowledge of insurance claims regulations, processes, and technology. This role is ideal for someone who can translate risk into actionable strategy and build sustainable compliance practices as Hiscox USA grows.

Key Responsibilities:

  • Manage and maintain 50-state claims database

  • Monitor legislation, DOI bulletins, court reporters/decisions, and statutory changes; manage backlog and implement targeted compliance training

  • Develop and own controls related to Medicare, OFAC, Child Support Lien Network, and other federal protocols

  • Partner with Claims Technical, US Legal, and IT to design controls and workflows aligned with regulatory requirements

  • Lead US Claims response to regulatory inquiries and complaints

  • Deliver training and legal support to internal teams and vendors

  • Develop audit programs and dashboards to monitor compliance effectiveness

  • Oversee/support technology-related compliance integrations

  • Provide executive reporting, trends analysis, and regulatory insights

Qualifications:

  • 10+ years of experience in claims compliance, insurance regulation, or legal operations

  • J.D. highly desired

  • Degree in law, risk management, or a related field; required

  • Advanced insurance compliance certifications a plus (CPCU, CIPP, CAMS, CRCM, or similar) Scrum/PMP a plus but not required

  • Deep understanding of claims handling regulations, Medicare protocols, and market conduct standards

  • Experience with multiple lines of business in a 50-state claims environment

  • Knowledge of Medicare Secondary Payer requirements and Section 111 reporting

  • Strong research and policy writing skills

  • Excellent collaboration, project management, and problem-solving skills

  • Experience with regulatory audit preparation and response

​Compensation: $90,000–$150,000 based on experience

The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment.  

About Hiscox USA :

Hiscox USA was established in 2006 to focus primarily on the needs of small and middle market commercial clients, via both the broker and direct distribution channels and is today the fastest-growing business unit within the Hiscox Group.  

Today, Hiscox USA has a talent force of about 420 employees mostlyoperating out of several major cities - New York, Atlanta, Chicago, West Hartford, and Scottsdale. Hiscox USA offers a broad portfolio of commercial products, including technology, cyber & data risk, multiple professional liability lines, media, entertainment, management liability, crime, kidnap & ransom, commercialproperty and terrorism.  

What We Offer: 

  • 401(k) with competitive company matching  

  • Comprehensive health insurance, vision, dental and FSA plans (medical, limited purpose, and dependent care)   

  • Company paid group term life, short- term disability and long-term disability coverage  

  • 24 Paid time off days plus 2 Hiscox days,10 paid holidays plus 1 paid floating holiday, and ability topurchase up to 5 PTO days  

  • Paid parental leave  

  • 4-week paid sabbatical after every 5 years of service  

  • Financial Adoption Assistance and Medical Travel Reimbursement Programs  

  • Annualreimbursement up to $600 for health club membership or fees associated with any fitness program  

  • Company paid subscription to Headspace to support employees’ mental health and wellbeing  

  • 2024 Gold level recipient of Cigna’s Healthy Workforce Designation for having a best-in-class health and wellness program  

  • Dynamic,creative andvalues-driven culture  

  • Modern and open office spaces, complimentary drinks  

  • Spirit of volunteerism, socialresponsibility and community involvement, including matching charitable donations for qualifying non-profits via our sister non-profit company, the Hiscox USA Foundation  

You can follow Hiscox on LinkedIn,Glassdoor andInstagram (@HiscoxInsurance).

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