Hybrid Claims TPA Governance Analyst

Posted 2 days ago

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About the role

  • Claims TPA Governance Analyst ensuring compliance with regulatory requirements for AIG’s TPA partners. Overseeing adherence to state and federal regulations impacting claims handling.

Responsibilities

  • Monitor changes in state, federal, and market conduct regulatory requirements impacting claims handling and TPA activities
  • Ensure TPA partners maintain compliance with claims regulations, including timeliness standards, documentation rules, licensing requirements, privacy laws, and unfair claims practices statutes
  • Identify compliance risks and support corrective action plans with internal stakeholders and TPA leadership
  • Prepare and support responses to Department of Insurance (DOI) inquiries, data calls, market conduct exams, and regulatory filings related to TPA-handled claims
  • Serve as a liaison between Claims, Compliance, Legal, and external TPA partners
  • Support the response to and compliance with state regulatory audits and fines

Requirements

  • Bachelor’s degree in business or related field and/or equivalent combination of experience; insurance or financial services industry preferred
  • Minimum 5 years prior experience working with TPAs in the NAM regulatory space
  • Knowledge of regulatory best practices and state, province, and carrier requirements
  • Understanding of quality controls and risk management disciplines is a strong asset
  • Proficiency in MS Excel (advanced formulas, pivot tables), MS Word, PowerPoint, and MS Outlook
  • Excellent communication skills (verbal, written, presentation)
  • Ability to influence and resolve complex regulatory issues
  • Strong organizational and customer service skills
  • Ability to prioritize multiple tasks and meet strict deadlines

Benefits

  • Comprehensive benefits package focused on health, wellbeing, and financial security
  • Professional development opportunities

Job title

Claims TPA Governance Analyst

Job type

Experience level

Mid levelSenior

Salary

Not specified

Degree requirement

Bachelor's Degree

Location requirements

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