Head of Claims Compliance, Employee Benefits (Detroit)

Head of Claims Compliance, Employee Benefits

About the Company

Prominent financial services company

Industry

Financial Services

Type

Privately Held

Founded

1859

Employees

5001-10,000

Categories

• Banking
• Consulting
• Financial Services
• Insurance
• Savings & Investing
• Consulting & Professional Services
• Investing
• Investment Management
• Financial Advisers
• Tax Services
• Risk Analysis
• Employee Management
• Asset Management
• Finance
• Manhattan
• New York City

Specialties

About the Role

The Company is seeking a Head of Claims Compliance for Employee Benefits. This pivotal role is responsible for overseeing the compliance framework in the administration of claims for a range of employee benefits products, including group dental, vision, life insurance, short and long-term disability, statutory benefits, paid family leave, and supplemental health offerings. The successful candidate will ensure that all claims processes adhere to relevant laws and regulations, establish and monitor key controls, and serve as the primary contact for internal and external claims-related audits. Additionally, the role involves managing records to ensure compliance, collaborating on business continuity plans, and acting as a privacy liaison to mitigate data privacy risks.

Applicants for the Head of Claims Compliance position must have a Bachelors degree, with a J.D. degree highly desired, and at least 10 years of experience in the employee benefits or group insurance industry, with a minimum of 5 years in direct claims compliance. The ideal candidate will have a strong understanding of compliance and internal controls, excellent interpersonal and communication skills, and the ability to build strong relationships. Experience with FINEOS claims software is a plus. The role requires a proactive individual with exceptional problem-solving and analytical skills, capable of driving continuous improvement in internal controls and ensuring the company's Powerfully Simple vision is supported through a rigorous compliance framework.

Hiring Manager Title

Head of Claims

Travel Percent

Less than 10%

Functions