Insurance Compliance Audit Specialist (Hybrid)
Company: American Medical Association
Location: Chicago
Posted on: January 24, 2025
Job Description:
Insurance Compliance Audit SpecialistChicago, IL (Hybrid)The
American Medical Association (AMA) is the nation's largest
professional Association of physicians and a non-profit
organization. We are a unifying voice and powerful ally for
America's physicians, the patients they care for, and the promise
of a healthier nation. To be part of the AMA is to be part of our
Mission to promote the art and science of medicine and the
betterment of public health. We continuously work to embed equity
in our internal practices and are committed to increasing the
diversity of our staff across all levels of the organization. We
intentionally work to create the right conditions to enable our
employees to feel that they can be their authentic selves and fully
participate in the life of the enterprise. We encourage and support
professional development for our employees, and we are dedicated to
social responsibility. We invite you to learn more about us and we
look forward to getting to know you. We have an opportunity at our
corporate offices in Chicago for a Insurance Compliance Audit
Specialist (Internal Title: Senior Compliance Specialist) on our
AMA Insurance Agency. This is a hybrid position reporting into our
Chicago, IL office, requiring 2 days a week in the office. As a
Insurance Compliance Audit Specialist, you will lead AMA Insurance.
quality assurance, carrier audit and
privacy compliance RESPONSIBILITIES:Quality Assurance
Work with business teams to ensure
services are completed in accordance with legal and contractual
standards/requirements Maintain the Company's standards, controls,
procedure framework, and policy assurance activities, working with
process owners across departments to keep documentation current and
supporting the Company's policy committeeCollaborate with
department leads to conduct ongoing monitoring of key processes
through reporting and review meetingsAssists with interview/fact
finding and analysis, presentation of recommendations to Company
leadership, remediation/root cause analysis, and process
improvementsCarrier Audits
Serve as lead contact for auditors
and coordinate carrier audits Represent the Company in carrier
audit meetingsReview draft findings, prepare appropriate written
responses to draft findings, and work across the Company (and its
vendors) to monitor and implement required improvements and
corrective action plans resulting from findingsPrivacy Compliance
Under the direction of the privacy
and security officers, support Agency's privacy program, including
the risk assessment process, evaluation of technology vendors and
related risks, security incident response, data subject access
requests, and information privacy and security policies and
proceduresUnder the direction of a Company attorney, support
drafting Business Associate Agreements and Data Processing
Agreements with third parties via contract negotiation
guidelinesUnder the direction of a Company attorney, support
Company's compliance with HIPAA, GBLA, and state privacy and
cybersecurity lawsLiaise with AMA Data Privacy Team on evolving
data privacy law and best practicesProduct and Trust Compliance
Serve as liaison between Agency and
carriers regarding product compliance issues,' including by
tracking carrier compliance requirements, reviewing requests,
gathering information as needed and leading implementation efforts
on required changesUnder the direction of a Company attorney,
prepare draft reports and responses for carriers and state
departments of insurance, including on complaints and
investigationsServe as a resource for Operations/Claims on
compliance related questions Maintain necessary policies and
certificates in trustsSupport of other projects or tasks as
assigned by the General Counsel
Prepare, create or maintain logs,
charts, or other planning documents as directed by General
CounselIndependently manage specific projects with minimal attorney
oversight. Collaborate/share responsibility with Agency OGC team
members for specified projectsMay include other responsibilities as
assigned REQUIREMENTS:Bachelor's degree required.5+ years
experience in insurance (carrier or third-party administrator)
required, preferably Life / HealthDemonstrated experience in
quality assurance in the service industry, compliance, or internal
audit Knowledge or willingness to acquire knowledge of privacy /
data security practices preferred; must be certified as CIPM within
twelve (12) months of hireProven ability to multi-task, manage
multiple priorities and meet conflicting deadlines. Demonstrated
Project management skillsExcellent communication skills and the
ability to work effectively with all levels in the organization, as
well as represent Company in communications with carriers and
Company vendorsAbility to work independently and with a team with
an emphasis on accuracy and timeThe American Medical Association is
located at 330 N. Wabash Avenue, Chicago, IL 60611 and is
convenient to all public transportation in Chicago. We are an equal
opportunity employer, committed to diversity in our workforce. All
qualified applicants will receive consideration for employment. As
an EOE/AA employer, the American Medical Association will not
discriminate in its employment practices due to an applicant's
race, color,
religion, sex, age, national origin, sexual orientation, gender
identity and
veteran or disability status.THE AMA IS COMMITTED TO IMPROVING THE
HEALTH OF THE NATION Apply NowShare Save Job
Keywords: American Medical Association, West Allis , Insurance Compliance Audit Specialist (Hybrid), Accounting, Auditing , Chicago, Wisconsin
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