Claims Compliance Specialist

This is your opportunity to join AXIS Capital - a trusted global provider of specialty lines insurance and reinsurance. We stand apart for our outstanding client service, intelligent risk taking and superior risk adjusted returns for our shareholders. We also proudly maintain an entrepreneurial, disciplined and ethical corporate culture. As a member of AXIS, you join a team that is among the best in the industry.

At AXIS, we believe that we are only as strong as our people. We strive to create an inclusive and welcoming culture where employees of all backgrounds and from all walks of life feel comfortable and empowered to be themselves. This means that we bring our whole selves to work.

All qualified applicants will receive consideration for employment without regard to race, color, religion or creed, sex, pregnancy, sexual orientation, gender identity or expression, national origin or ancestry, citizenship, physical or mental disability, age, marital status, civil union status, family or parental status, or any other characteristic protected by law. Accommodation is available upon request for candidates taking part in the selection process.

AXIS Capital

Claims Compliance Specialist, Claims Shared Services- Job Description

AXIS is seeking a Claims Quality Assurance and Compliance Specialist, Claims Shared Services to join our Shared Services Claims team. As a direct report to the Head of Quality Assurance and Compliance, Claims Shared Services, the successful candidate should possess the ability to support the development and execution of the North America Claims Quality Assurance and Compliance program for AXIS North America Claims. The successful candidate will promote a continuous improvement culture, support the framework, benchmarks and identify areas for improvement for compliance of AXIS North America Claims with an immediate focus on Adjuster Licensing and Medicare Compliance. The successful candidate is a results-driven team player with a can-do mindset focused on continuous improvement and will support claims compliance objectives and strategies in partnership with AXIS North America Claims Leadership and related internal stakeholders.

The successful Candidate will be responsible for :

• Assisting with day-to-day management of AXIS North America Claim Quality Assurance and Compliance objectives.
• Assisting and collaborating with other departments and stakeholders (e.g., Legal & Compliance, Internal Audit, Finance, North America Claims and Claims Operations etc.) to ensure that Quality Assurance and Compliance related processes are identified, created, implemented, maintained, and continuously improved.
• Supporting the drafting of North America Claim Quality Assurance and Compliance policies, procedures, standards, processes, workflows, guidelines training, and other documents necessary to drive compliance initiatives for AXIS North America Claims in support of a center of excellence within NA Claim Quality Assurance and Compliance.
• Collaborating with stakeholders identifying, investigating, resolving, tracking, and reporting on North America Claim Quality Assurance and Compliance matters and opportunities.
• Responsible for supporting and providing operational support to document and maintain an accurate and compliant AXIS Claims Adjuster Licensing program, continuously improving, and enhancing this function to comply with, regulatory requirements and providing assistance to NA Claim handlers problem solve and source solutions with reciprocity questions and continuous education requirements.
• Responsible for tracking, measuring, and reporting to internal stakeholders' status claim adjuster licensing requirements in partnership with a third-party vendor and other management tools to assist with the effective and compliant management of adjuster licenses.
• Assisting with maintenance of Medicare policies and procedures, monitoring, summarizing, tracking compliance objectives and timelines in partnership with a third-party vendor, reporting to internal stakeholders to support and provide operational support to document and maintain an accurate and compliant AXIS North America Claim Medicare reporting program.
• Assisting with maintenance of SIU, Fraud reporting and other Compliance reporting and procedures as these may be required, monitoring, summarizing, tracking compliance objectives and timelines in partnership with a third-party vendor, reporting to internal stakeholders.
• Responsible to gather, organize and analyze Quality Assurance and Compliance data and results to identify and report on performance, trends, and opportunities continuously striving for opportunities to improve.
• Assist and support execution and delivery of monthly, quarterly, and annual dashboard reporting for Quality Assurance and Compliance metrics to drive continuous improvement, in collaboration with key Axis stakeholders.
• Support and collaborate as required with Axis Claims Leadership and related internal stakeholders on training initiatives, job aids, guidelines to continuously improve claims handling quality and execution in support of team and individual professional growth and development.
• Building and maintaining key relationships with internal stakeholders (e.g., Peers, Underwriting, Actuarial, various executive management leaders) and external stakeholders. (e.g., auditors, reinsurers, and vendors)
• Providing input and feedback as needed to stakeholders in support of Claims business strategies and processes. May be asked to serve as a subject matter expert with respect to North America Claim Quality Assurance and Compliance matters.
• Maintain effective and ongoing communication with claims department leaders and staff, internal and external business partners, insureds, claimants, agents, attorneys, other insurance companies, project team members, claims leadership, and vendors.
• Assist with all other Quality Assurance and Compliance related tasks and initiatives as needed

KEY SKILLS & ABILITIES :