Regulatory Compliance Specialist


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Position Description

Performs regulatory activities for the Company and all of its subsidiaries and affiliates to ensure legislative and regulatory compliance. Required to operate cross functionally and in areas with ambiguity and complexity from both a legal and healthcare insurance frame of reference.

Essential Functions:
• Creates necessary form filings to accommodate new products and changes to existing forms and submits form filings to regulators for regulatory approval through the System for Electronic Rate and Form Filings (“SERFF”) where possible. Monitors filing inquiries from regulators, works with operational areas and compliance to develop response to regulators objections, prepares response letters, and modifies contractual forms with compliance approval as needed until final regulatory approval is received
• Maintains current records of all approved forms
• Develops regulatory policies, procedures and related compliance tools
• Assists in the development of and reviews department policies and procedures in support of products
• Prepares documents for corporate compliance filings as well as certain regulatory filings with state licensing and insurance departments while serving as a resource/administrator for such filings
• Assists in the preparation and administration of business associate agreements, and confidentiality and non-disclosure agreements
• Investigates alleged privacy breaches and performs risk assessment.
• Handles complex regulatory compliance issues
• Leads non-financial regulatory surveys and exams
• Keeps abreast of the changing legal and regulatory landscape
• Researches insurance laws applicable to industry
• Researches and interprets regulatory requirements of new products and product enhancements
• Performs continual audit procedures with a high degree of accuracy and confidentiality
• Performs other miscellaneous duties as assigned

• Bachelor’s Degree required
Certificate Program in Paralegal Studies or equivalent education helpful
• 5+ years experience in a regulatory environment or healthcare-related field
• Understanding of health/dental insurance products with product filing experience
• Background in use of SERFF filing system
• Knowledge of state and federal regulations as they pertain to product filings
• Regulatory research skills and experience
• Ability to work independently and as part of a team in a fast paced environment
• Ability to multi-task and meet demanding deadlines
• Ability to learn new software programs
• Achieved attention to detail and accuracy
• Strong analytical skills and problem solving capabilities
• Strong organizational and project management skills
• Excellent oral and written communication skills
• Proficiency in: MS Word, Excel, PowerPoint, PDF Converter; experience with HIOS and ACL Analytical software helpful