[Remote] Claims Compliance Penalty Analyst
Note: The job is a remote job and is open to candidates in USA. biBerk Business Insurance is seeking a Claims Compliance Penalty Analyst to join their Claims Compliance team. This role involves overseeing, enforcing, and reducing fines and penalties across various property and casualty lines of business, ensuring compliance with regulations and internal policies.
Responsibilities
- Monitor, track, and manage workers’ compensation penalties to ensure timely and accurate processing in accordance with state regulations
- Review, evaluate, and authorize penalty payments in alignment with regulatory requirements, contractual obligations, and internal compliance standards
- Investigate, evaluate, and dispute penalty assessments when appropriate
- Partner with Third-Party Administrators (TPAs) to address penalty issues, including recovery and recoupment of inappropriate or avoidable costs
- Analyze penalty drivers, trends, and root causes to identify opportunities for risk reduction and process improvement
- Support the intake, tracking, and resolution of complaints, ensuring adherence to regulatory timelines and standards
- Collaborate with claims leadership and operational teams to improve processes, enhance compliance, and reduce risk exposure
- Maintain accurate reporting and provide insights for leadership on compliance performance, risks, and improvement opportunities
- Assist in the development and documentation of penalty-related compliance procedures and best practices
- Ensure timely and accurate documentation of penalty decisions and related compliance actions
- Manage and support penalty disputes, appeals, and negotiations, coordinating with internal stakeholders and external entities as needed
- Support training initiatives by educating claims staff on penalty standards, compliance expectations, and risk mitigation practices
Skills
- Bachelor's degree
- 5+ years of experience in claims handling, compliance, risk management, or penalty/dispute resolution
- Strong working knowledge of claims regulations, contractual compliance, and penalty frameworks
- Experience analyzing complex claim data and compliance trends
- Excellent written and verbal communication skills
- Strong judgment, attention to detail, and decision making ability
- Experience in workers' compensation claims, compliance, or regulatory environments
- Strong understanding of state-specific workers' compensation regulations and penalty requirements
- Analytical mindset with the ability to interpret data and identify trends
- Strong attention to detail and ability to manage multiple priorities
- Effective communication and problem-solving skills
Benefits
- Medical (PPO/HDHP), vision, disability, and life insurance.
- Enhanced dental plan with orthodontia coverage in addition to a standard plan.
- Generous PTO plan for all benefit-time eligible employees.
- Paid company holidays and 4 floating holidays.
- Paid parental leave.
- Employee Retirement Savings Plan/401(k) with company match and immediate vesting.
- Education Assistance Program that offers 100% upfront tuition reimbursement after 6 months of service for approved degree programs.
- Service Recognition Program that provides a monetary award to be used toward a vacation every 5 years of employment.
- Wellness Initiatives that include Fitness Center and Weight Watchers Reimbursement programs.
- Voluntary benefits that include accident, critical illness, and hospital indemnity.
- Employee discount and rewards program on travel, tickets, electronics, home, and more.
Company Overview