Head of claims compliance benefits
At Equitable, our power is in our people. We're individuals from different cultures and backgrounds. Those differences make us stronger as a team and a force for good in our communities. Here, you'll work with dynamic individuals, build your skills, and unleash new ways of working and thinking. Are you ready to join an organization that will help unlock your potential?
Equitable is looking for an experienced expert to join our team! The Head of Claims Compliance will oversee all aspects of our Employee Benefits (EB) Claims compliance framework. Reporting directly to the Head of Claims, this role is pivotal in ensuring compliance with regulatory and legal requirements in the administration of claims for our Employee Benefits product suite, with includes group dental, vision, life insurance, short and long term disability, statutory benefits, paid family leave, as well as supplemental health offerings, including accident, critical illness, hospital indemnity, and associated wellness benefits. This individual must be able to help deliver Employee Benefits’ “Powerfully Simple” vision, by supporting the Employee Benefits claims organization with a rigorous compliance framework. Key Job Responsibilities- Compliance: Ensures all claims processes comply with relevant laws and regulations. Stays current regarding updated changes in legislation and adjusts advice accordingly.
- Key Controls: Establishes and monitors key controls within the EB Claims organization, including SOX compliance. Partners with members of the EB Claims leadership team and internal control functions.
- Audit Oversight: Ensures internal and external audit needs are well-coordinated and serves as the primary point of contact for internal and external claims-related audits, including market conduct.
- Records Management: Serves as the primary contact for items related to claims records management, to ensure full compliance with internal and external guidelines and regulations.
- Business Continuity: Collaborates on the EB Claims business continuity plan and works with internal and external vendor stakeholders to ensure plans are robust and revisited regularly.
- Privacy Liaison: Collaborates with enterprise privacy partners to ensure privacy outages are mitigated and coordinates prevention and control mechanisms related to claims data privacy.
- Performs other duties as assigned.
- Bachelor’s degree
- 10+ years of experience in the Employee Benefits / Group Insurance industry
- 5+ years of direct experience with claims compliance in an Employee Benefits setting
- Specific prior experience supporting one or more of the following products: group dental, vision, life insurance, short/long term disability, statutory benefits, paid family leave, and/or supplemental health offerings (accident, critical illness, hospital indemnity, and associated wellness benefits).
- J.D. degree highly desired
- Experience with FINEOS claims software a big plus
- Strong understanding of compliance and internal controls
- Excellent interpersonal and relationship building skills
- Exceptional verbal and written communication skills
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