Senior Program Claims Compliance Specialist

Argo Group is a leader in specialty insurance with a vibrant culture built on respect, equality, wellness and opportunity. We’re an innovative organization that’s small enough to be agile and big enough to make a difference in our industry.  

Our collaborative workplace is continuously evolving to ensure all employees feel: 

• Comfortable bringing their whole selves to work. 
• Confident that they will be treated respectfully. 
• Recognized for their performance and provided with equal opportunities to succeed. 

At Argo, skill meets opportunity. If you’re wired to raise your hand and ask, “Where can I help?”, you’ll thrive with us. 

Argo Group is a leader in specialty insurance with a vibrant culture built on respect, equality, wellness and opportunity. We’re an innovative organization that’s small enough to be agile and big enough to make a difference in our industry.

 

Our workplace is continuously evolving to ensure all employees feel:

• Comfortable bringing their whole selves to work.
• Confident that they will be treated respectfully.
• Recognized for their performance and provided with equal opportunities to succeed.

 

At Argo, skill meets opportunity. If you’re wired to raise your hand and ask, “Where can I help?”, you’ll thrive with us. At Argo Group, you can make a direct impact while working in an organization small enough to be agile and big enough to make a difference. We ask you to bring a growth mindset and a desire to share your unique perspective with our dynamic teams.

 

Argo Group, a global multiline underwriter of specialty insurance and reinsurance products in the property and casualty market, offers a comprehensive line of high-quality products and services designed to meet the unique coverage and claims-handling needs of our clients. We foster an inclusive culture that embraces diversity and design thinking, relies on innovation and agility, promotes collaborative service delivery, frequent, integrated communication, and authentic recognition of excellence.
 

A Brief Overview

We are looking for a highly capable Program Claims Compliance Specialist to join our team and work from any of our US offices in Chicago, Los Angeles, New York City, Omaha, Richmond (VA), Rockwood (PA), or San Antonio. This individual will provide a wide range of administrative support to our Programs Department and perform EDI processing, reporting, and resolution.

 

The role will work onsite (5 days per week) at one of our office locations: Los Angeles, CA, Omaha, NE, San Antonio, TX, Chicago, IL, New York City, NY, or Richmond, VA.

 

The primary duties and responsibilities of the role are:

• Under close supervision and guidance, works within narrowly defined limits and authority, assist our Program claims department with TPA compliance, program management and special projects with an impact on departmental results.
• Resolving issues that are generalized and typically not immediately evident, but typically not complex and within immediate job area.
• Partner in production of multiple reports for state compliance, TPA reporting and summary reporting.
• Perform TPA payment audits and provide audit assistance to TPA’s request for documents and communications
• Liaison for DTS on data feed maintenance
• Schedule claim reviews, collect claim summaries and distribute
• Complete annual imprest reviews while evaluating imprest levels for appropriateness
• Partner with Claim Support in finding policy information/program TPA’s with limited insured information 
• Assist with audit reports and tracking
• Responsible for making independent adjustments or recommended enhancements in ad hoc special projects utilizing related business expertise
• Manage TPA due diligence process and response rate though payment and compliance audits, TPA questionnaires, E&O Policy review and state licensing reviews.
• Responsible for SharePoint site updating and IT onboarding for Claims adjuster access.
• Support new Program/TPA implementations 
• Manage Cash calls and process, Replenishments, Claim Fees and escrow.
• Provision new TPA’s and review existing access for Argo systems
• Manage combined trial calendar and set diaries for Account Managers 
• Point of contact for new law firm approval and legal fee change request process 
• Maintain internal program and TPA adjuster directories and service instructions
• Provide support to MGA issue resolution
• Perform EDI processing, reporting, and resolution.