Senior Program Claims Compliance Specialist

As a Senior Program Claims Compliance Specialist at Argo Group, you'll handle various responsibilities including assisting the Program claims department with TPA compliance and program management, performing EDI processing and reporting, and conducting audits. You'll serve as a liaison for data maintenance, schedule claim reviews, manage TPA due diligence, and provide audit assistance, among other tasks. This role is crucial in ensuring that our processes meet compliance standards while also supporting our team with valuable insights.

To apply for the Senior Program Claims Compliance Specialist role at Argo Group, candidates should have a minimum of six years of experience in the insurance industry, preferably within a commercial claims department. Financial acumen is vital, along with advanced knowledge of EDI and ISO. While a Bachelor's degree or relevant industry designations are preferred, they are not a strict requirement. The emphasis is placed on excellent communication skills, curiosity, and a proactive approach to resolving issues effectively.

Yes, the Senior Program Claims Compliance Specialist position at Argo Group requires the candidate to work on-site five days a week. This aligns with our commitment to fostering a collaborative environment where team interactions drive optimal results. Our offices are located in various cities across the U.S., including New York City, Chicago, and Los Angeles, allowing you to choose a workplace that suits you best.

As a Senior Program Claims Compliance Specialist, you'll find that Argo Group fosters a dynamic and inclusive company culture. Our values emphasize respect, collaboration, and integrity, encouraging employees to bring their whole selves to work. We believe in continuous learning, innovation, and the power of diverse perspectives, making this a great place for you to thrive professionally while making a significant impact in the insurance industry.

At Argo Group, career development is a core value. As a Senior Program Claims Compliance Specialist, you'll have access to Argo Academy, which offers various learning and professional development options. We encourage career mobility and actively support continued education and professional designations. Our flat organizational structure also promotes open communication, providing you with opportunities to interact with senior management and influence decisions.

When discussing TPA compliance in an interview, focus on your systematic approach: start by detailing your process for monitoring compliance regulations, describe how you assess TPAs, and share specific examples where you resolved compliance issues. Emphasize the importance of maintaining communication with TPAs and stakeholders to ensure smooth operation.

In your response, highlight your hands-on experience with EDI systems. Discuss the types of transactions you've processed, challenges you've faced, and how you've ensured data accuracy and timeliness. Use specific metrics or results if possible, showcasing your skills in reporting and resolution.

Select a significant audit experience and walk the interviewer through your methodology: from planning, executing, to reporting findings. Mention any roadblocks you encountered and how your problem-solving skills led to successful resolution, demonstrating your analytical skills and attention to detail.

Explain your communication strategies that foster trust and collaboration. Discuss how you ensure stakeholders are informed on compliance processes and changes, and how you maintain accessibility for queries, emphasizing your commitment to strong, productive relationships.

Outline your organizational skills and how you manage time for multiple priorities. Share tools or methods you use to keep track of tasks, including setting deadlines and regularly reviewing progress, ensuring you're always moving towards your goals efficiently.

Express your passion for compliance and its impact on the industry. Discuss how compliance helps maintain integrity in the insurance process and how you enjoy contributing to safeguarding both the company and clients, underscoring your dedication to ethical practices.

Emphasize your proactive nature regarding professional development. Mention specific courses, seminars, or certifications you’ve pursued, and how you utilize resources like Argo Academy to enhance your knowledge and skills in compliance and the insurance field at large.

Show your knowledge about Argo Group by summarizing their mission of providing innovative insurance solutions and their commitment to respect and equality. Highlight how these values align with your own principles, emphasizing that you're not only looking for a job but a company whose culture resonates with you.

Detail a specific instance where you identified inefficiencies in a process and the steps you took to rectify them. Discuss the outcome and how those changes positively impacted team productivity or compliance rates, demonstrating your proactive problem-solving skills.

Provide a thoughtful analysis of current industry challenges such as regulatory changes, evolving technology, or data privacy issues. Suggest potential strategies to address these challenges, showing your insight into the landscape and your capacity for strategic thinking.