Insurance Consumer Analyst I
About The Position
The North Carolina Department of Insurance's mission is to promote a stable insurance market through unbiased regulation and to protect the lives and property of every citizen in all 100 counties while fostering superior, user-friendly service, courtesy, and respect. Our agency licenses insurance agents, adjusters, bail bondsmen and more, along with investigating fraud matters involving insurance consumers and any entity or individual regulated by the Department. In an ever-changing environment, it is the vision of the Department of Insurance to maintain the stabilization of the insurance industry in order to provide more products, competitive prices and consumer protection. This position currently qualifies for a hybrid telework option with routine office and 1 remote workday. The NC Department of Insurance trusts our employees to be self-motivated and successful in hybrid/remote roles. Telework options are subject to change at the discretion of management. The primary purpose of this position is to provide counseling and education to consumers on health insurance issues for Medicare beneficiaries via the national toll-free line and in-person meetings to include virtual assistance. This includes determining the consumer's needs, gathering correct information and answering the caller's question/inquiry. This requires extensive knowledge of Medicare, Medicare Supplements, Long-Term Care insurance, Medicare Managed Care, Medicare Prescription Drug Plans, medical claims procedures, and Medicare fraud, waste, and abuse. Should the consumer's inquiry require research then this position is to provide information to the appropriate staff member to research the problem and/or question and provide follow-up to the caller with an answer. There are situations when it is appropriate to make referrals to other applicable sources of assistance. This may include social service agencies, other state and federal agencies, or whatever community resource is available to handle a specific problem.
Requirements
- Bachelor's degree in business or economics or a related program from an appropriately accredited institution and one year of experience in insurance underwriting, claims, or policyholder service; or an equivalent combination of education and experience.
Nice To Haves
- Knowledge of health insurance laws and procedures, as well as Medicare laws and claims practices.
- Extensive knowledge on Medicare Supplement, Medicare Managed Care, Medicare Drug Plans, and Long-Term Care insurance products.
- Considerable communication and organizational skills.
- Ability to relay information by telephone and in-person to consumers, predominately senior citizens and disabled individuals, in a concise, clear manner.
- Patience and politeness are critical when speaking with elderly and disabled persons.
Responsibilities
- Provide counseling and education to consumers on health insurance issues for Medicare beneficiaries via the national toll-free line and in-person meetings to include virtual assistance.
- Determine the consumer's needs, gather correct information and answer the caller's question/inquiry.
- Provide information to the appropriate staff member to research the problem and/or question and provide follow-up to the caller with an answer.
- Make referrals to other applicable sources of assistance, such as social service agencies, other state and federal agencies, or community resources.
Benefits
- 12 Annual paid Holidays
- North Carolina State Health Plan administered by AETNA
- Supplemental Benefits including: Flexible Spending Accounts, Accident Insurance, Cancer & Specified Disease, Critical Illness, Dental and Vision
- NC State Retirement (TSERS)
- WeSave Employee Discounts
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
