Specialist, Contract Compliance II

Posted:
8/23/2024, 8:03:17 AM

Location(s):
Columbia, South Carolina, United States ⋅ South Carolina, United States

Experience Level(s):
Junior ⋅ Mid Level ⋅ Senior

Field(s):
Legal & Compliance

Workplace Type:
Hybrid


Summary
 

Researches and interprets insurance laws pertaining to division products form filings and obtains approval from the various state insurance departments. Communicates impact of insurance bulletins, circulars, and directives to appropriate departments and ensures compliance with all laws and regulations.


Description
 

Summary

Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation’s leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!

Logistics:

This is a full-time position (40-hours/week) with potential to work a hybrid schedule after an initial training period at 1301 Gervais St. Columbia SC. Please note this is subject to change based on employee performance and/or business need.

What You’ll Do:

  • Researches insurance statutes, regulations, and bulletins for policy form filings. Prepares formal contract filings and secures insurance department approval. Performs preliminary research on state and federal requirements pertaining to new market opportunities. Advises management of potential problem areas pertaining to emerging opportunities and current core products.

  • Reviews, revises, and assists in drafting marketing, reinsurance, and administrative agreements. Identifies contractual deficiencies in written agreements and recommends appropriate revision. Coordinates the review of all contracts with Companion's legal staff, if necessary.

  • Prepares, maintains, and files reports and corporate documents that pertain to core products and required by various state insurance departments and federal agencies.

  • Maintains and operates policy and certificate issue systems. Designs and programs paragraph logic and codes to ensure proper benefit selections and state variables print correctly. Troubleshoots the systems to ensure policy and certificate systems remain uninterrupted.

  • Communicates impact of insurance department bulletins and federal opinions to compliance manager and specialty product staff, and prepares response when required. Communicates the compliance department's summary of pertinent insurance department bulletins, circulars, and directives and all federal opinions and directives to appropriate company personnel. Provides clarification regarding technical interpretations.

  • Receives, logs, and distributes complaints (insurance department and consumer) pertaining to core products for response and follow up to ensure timely response. Develops, updates, and maintains procedure manuals to ensure maximum job performance and timeliness.

  • Researches state insurance statutes, regulations, bulletins, and NAIC models as requested by compliance manager, companion's legal department, and specialty product staff.

To Qualify for This Position, You’ll Need:

  • Bachelor's Degree and 5 years insurance experience, 4 of which must be in insurance compliance

OR

  • Associate's degree and an added 2 years of job-related work experience for a total of 7 years related experience

OR

  • 9 years job related work experience

  • Strong knowledge of insurance statutes and regulations and ERISA.

  • Strong written and verbal communication skills.

  • Experience with Microsoft Office.

What we Prefer you to have:

  • Bachelor's degree- Business Administration or other related field

  • 5+ years-experience in insurance compliance and insurance research.

  • Ability to work under minimal supervision.

What We can Do for You:

We offer our employees great benefits and rewards.  You will be eligible to participate in the benefits the first of the month following 28 days of employment.  

  • Subsidized health plans, dental and vision coverage

  • 401K retirement savings plan with company match

  • Life Insurance

  • Paid Time Off (PTO)

  • On-site cafeterias and fitness centers in major locations

  • Wellness program and healthy lifestyle premium discount

  • Tuition assistance

  • Service recognition

  • Employee Assistance

  • Discounts to movies, theaters, zoos, theme parks and more

What to Expect Next:

After submitting your application, our recruiting team members will review your resume to ensure your meet the qualifications.  This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. If the qualifications required proof of semester hours, please attach your transcript to your application.

Management will be conducting interviews with the most qualified candidates, with prioritization give to those candidates who demonstrate the preferred qualifications.



 

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.

Some states have required notifications. Here's more information

Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains Affirmative Action programs to promote employment opportunities for minorities, females, disabled individuals and veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities.

If you need special assistance or an accommodation while seeking employment, please e-mail [email protected] or call 1-800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.