Description:

An Insurance Company has an immediate opening for a Senior Regulatory Counsel that can report to any of the following An Insurance Company locations:

Alpharetta, Georgia
Raleigh, North Carolina

This role is responsible for overseeing legal review of Regulatory Compliance matters and driving internal education and initiatives for regulatory reporting and claims best practices. Please note, IAT works on a hybrid schedule, working from the office Monday through Wednesday with the option of working remotely Thursday and Friday.

Key Responsibilities:

Serve as in-house counsel responsible for responding to Legal and Regulatory Matters for Property and Casualty Claims.
Provide legal advice and regulatory opinions to be used by Claims, Underwriting, and other internal business partners.
Advise Claims and Underwriting of statutory and legal developments and emerging trends impacting the insurance industry regulations and Department of Insurance mandates.
Assist Claims and other business units in their handling of claims and litigation in compliance with Claims Best Practices to ensure claim handling discipline and superior Quality Review and Audit scores, including timely coverage reviews and coverage correspondence.
Provide opinions and legal guidance to Property and Casualty Claims regarding coverage disputes, extra-contractual claims, declaratory judgment actions, and claims best practices requirements.
Manage claims systems and data for accuracy and timely reporting.
Assist Claims Leadership by identifying litigation trends, providing legal updates and training regarding emerging policies, cases, statutes, and regulations impacting the insurance industry.

Regulatory Compliance:

Monitor and ensure Company compliance with federal, state, and local regulations. Stay updated on changes in laws and regulations that may affect the Company, its claims handling, and business practices.

Policy Development:

Work in conjunction with other leaders in the Legal Department to develop, implement, and maintain compliance policies and procedures.

Training and Education:

Develop and deliver training programs to educate employees on compliance-related topics and promote a culture of compliance within the Company.

Audits and Assessments:

When necessary, interface with internal and external stakeholders to respond to Department of Insurance and other regulatory audits and requests for information. Oversee regulatory audits and Department of Insurance on-site meetings. Communicate any regulatory findings and directives to senior management.

Department of Insurance Complaints:

Work collaboratively with adjusters, Managers, and Claims Leaders to ensure the Company timely and accurately responds to Department of Insurance Complaints lodged by policyholders.

Reporting:

Prepare and present compliance reports to senior management. Maintain accurate records of compliance activities and findings.

Investigations:

When necessary, conduct internal investigations into compliance issues and complaints. Work with colleagues in the Legal Department to resolve issues and implement corrective action.

Collaboration:

Collaborate with various departments, including Claims, Underwriting, HR, and Operations to ensure a cohesive approach to compliance.
Perform other legal and litigation duties as assigned.

Qualifications:
Must Have:

Juris Doctor from an accredited law school required.
At least 5 years of relevant legal experience, which focused on insurance industry Regulatory Compliance, Claims Best Practices, ISO and Medicare Reporting, and regulatory audits.
Strong understanding of regulatory requirements and compliance standards in the insurance industry.
Proficiency in compliance software and tools, including tools used for ISO reporting and Medicare reporting.
Must have State Bar License that is in good standing.
Must have insurance and extra-contractual litigation experience.
Excellent oral and written communication skills.
Excellent customer service and interpersonal skills.
Advanced critical thinking and problem-solving skills.
Ability to set priorities and multitask in a fast-paced environment.
Ability to travel if required.

Preferred to Have:

Experience working with an insurance company a plus.
Experience handling coverage disputes involving first-party property and/or third-party liability claims with an exposure of $250,000 or more including both primary and excess losses preferred.