Senior Claims Compliance Analyst

Oliver James
Boston, MA

Job Summary / Introduction

  • Senior compliance role supporting US insurance claims operations

  • Responsible for strengthening regulatory controls and claims governance

  • Acts as a subject matter expert for claims compliance and regulatory risk

  • Supports a complex, multi-jurisdictional claims environment

Detailed Job Description

  • Own claims compliance oversight across all US jurisdictions

  • Track and interpret regulatory, legislative, and legal developments impacting claims

  • Translate regulatory change into operational guidance, controls, and training

  • Maintain enterprise claims compliance requirements and documentation

  • Design and manage controls tied to federal and state claims obligations

  • Collaborate with Claims, Legal, and Technology teams on compliant workflows

  • Lead regulatory inquiries, complaints, and claims-related examinations

  • Develop compliance monitoring, audits, and reporting dashboards

  • Support claims systems enhancements and compliance integrations

  • Deliver insights and trend reporting to senior leadership

Skills & Experience

  • 8+ years of experience in insurance claims compliance or regulation

  • Bachelor's degree in a relevant discipline required

  • Professional compliance or insurance certifications preferred

  • Strong knowledge of claims regulations, market conduct, and federal protocols

  • Experience supporting multiple lines of business across all US states

  • Medicare Secondary Payer and Section 111 reporting expertise

  • Regulatory audit and examination experience

  • Strong analytical, writing, and stakeholder communication skills




If interested, please apply to this job advert or reach out to [email protected]

Posted 2026-03-03

Recommended Jobs

Summer Helper

Massachusetts Municipal Wholesale Electric Company (MMWEC)
Ludlow, MA

MMWEC is seeking an energetic, hardworking individual for our Summer Help position within the Facilities Department. This is a seasonal role only , perfect for students or anyone looking for a co…

View Details
Posted 2026-02-24

Food Champion

Taco Bell
Allston, MA

As a Food Champion, you will be responsible for: Using the correct tools to prepare, build and present perfect food Serving food that meets our quality standards Maintain a clean, neat and w…

View Details
Posted 2026-01-28

Higher Education Market Leader

NBBJ
Boston, MA

NBBJ is an award-winning design firm recognized as a TIME100 Most Influential Company, a Fast Company Most Innovative Architecture Firm and a two-time 2025 AIA National Honor Award recipient. These …

View Details
Posted 2026-01-28

Specimen Accessioner - 3rd Shift

Covance Inc.
Holyoke, MA

Are you organized, accountable, and have always gone the extra mile to make sure things are done right? Imagine the impact those skills can have in ensuring the accuracy of millions of healthcare tes…

View Details
Posted 2026-02-20

Board Certified Behavior Analysis School based- $100/HR

Boston Speech Therapy
Randolph, MA

BCBA needed full time - K-12 School 16 hours a week- $100/HR FEB-June 2025 $70/HR K-12th grade Consult only with teachers (no direct therapy or supervision needed) Flexible! SLP …

View Details
Posted 2025-09-03

LVN/LPN- Home Health- Marlborough MA

Precision Life Sciences
Marlborough, MA

Job Title: LVN / LPN – Home Health Location: Marlborough MA Employment Type: Contract Shift: 8 Hour Day ~ Pay Rate: up to $1700 weekly + benefits from day 1! Job Summary: We ar…

View Details
Posted 2026-01-19

Medical Director - Psychiatrist

Boca Recovery Center
Worcester, MA

Medical Director – Licensed Psychiatrist Location: Hybrid – Springfield, Massachusetts Department: Medical Salary: Competitive, based on experience About Boca Recovery Center…

View Details
Posted 2025-11-28

Director of Marketing

Together Light
Hampshire County, MA

**Title:** Director of Marketing / Director of Paid Ads and Influencer Marketing Specialist **Work Setup:** Full-time, Remote **Rate:** $20 – $40 per hour * Can You Lead a High-Performing Marketin…

View Details
Posted 2026-02-23

Remote - Project Manager (East Coast or Central time zone)

Insight Global
Boston, MA

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of …

View Details
Posted 2026-02-09

Ordinance Disposal Specialist - Army

U.S. Army
Lowell, MA

ORDNANCE DISPOSAL SPECIALIST Overview: As an Explosive Ordnance Disposal Specialist, you’ll be the Army’s preeminent tactical and technical explosives expert. You’ll have the advanced trainin…

View Details
Posted 2025-08-12