Renewal Specialist - Lead Worker

Blue Cross Blue Shield of Michigan•Lansing, MI

2d•Onsite

About The Position

In addition to fulfilling the primary responsibilities of a Renewal Specialist, this role will also focus on serving as a lead worker in the Renewal Specialist department by assisting with quality, compliance and customer facing measures. Assisting staff with technical questions and provide mentoring to current and new staff. This role will also serve as a Subject Matter Expert, as well as participating in enterprise projects. Primarily responsible for assisting Business Development Consultants (BDCs) in growing and maintaining a profitable book of business and assists agents with inquiries related to underwriting rules, procedures, and regulations. Manages renewal book in accordance with the needs of the region they are aligned with. Mentors Renewal Specialists with complex agency/insured questions and policy information. Reviews policy structures to determine if changes need to be made to stay in compliance with bureau rules and regulations. Provides customer service to agencies and policyholders related to complex underwriting inquiries, policy, and audit information. Contacts include state rating bureaus, Business Development Consultants, Business Development Directors, Service Center Managers, Underwriting Technical Advisor, Service Center staff, Finance Department, Claims Department, agents, and policyholders.

Requirements

Bachelor’s degree in insurance and/or a related field with progress towards or completion of Insurance Institute of America (IIA) or other insurance-related designation(s).
Successful completion of business writing course required.
Combinations of education and experience may be considered in lieu of formal education.
Three (3) years experience as a Renewal Specialist – Small Accounts.
Three (3) years as an Underwriting Technical Specialist (I/II), including one (1) year as a Underwriting Technical Specialist II, with demonstrated technical decision making and interpretation of policy contract language and underwriting knowledge.
Experience with interpretation of and application of manual rules across multiple states and regulatory authorities.
OR Master’s degree in business, insurance, or related field with progress toward or completion of Insurance Institute of America (IIA) or other insurance related designation(s).
And Three years AF Group experience working with underwriting/bureau rules, procedures, policy and audit information and research of business elements pertinent to policy structure; reviewing and approving endorsement requests or customer service experience resolving premium billing and premium transaction activities for agents and policy holders.
Ability to objectively review the work of others to ensure quality output.
Demonstrated knowledge of team workflow and ability to re-prioritize work as needed for self and others.
Ability to work effectively in a multi functional multi-state business unit.
Knowledge of state specific underwriting and audit rules, procedures, and Workers’ Compensation classifications in multiple states.
Basic understanding of the worker’s compensation claims process as it relates to the underwriting process.
Knowledge of workers compensation underwriting terminology and concepts
Excellent verbal and written communication skills.
Strong interpersonal skills and the ability to create and maintain mutually beneficial relationships with working partners.
Excellent organizational skills, including ability to perform multiple tasks, and prioritize.
Ability to manage multiple priorities and meet established deadlines.
Knowledge of word processing with accurate input ability of 40 wpm.
Advanced knowledge of spreadsheet software with the ability to use ten-key.
Knowledge of computers.
Basic knowledge of database software.
Strong analytical and problem-solving skills.
Knowledge of multi-line telephone system
Ability to process transactions on core processing systems.
Ability to proofread documents for accuracy of spelling, grammar, punctuation, and format.
Math skills with the ability to use a ten-key adding machine.
Ability to recognize and negotiate solutions for unique requests.
Knowledge of state specific underwriting and audit rules & concepts; workers compensation classifications and procedures; and application of manual rules across all core and non-core states and regulatory authorities.
Ability to think proactively and independently with a long-term perspective in addressing customer’s needs.
Demonstrated technical knowledge of policy exposures, implications of changes, and identifying unique situations.

Nice To Haves

Thorough knowledge of state specific underwriting and audit rules, procedures, and Workers’ Compensation classifications in multiple states.
Prefer completion of Certified Authority on Workers Compensation (CAWC) Insurance Institute of America (IIA) or other insurance related coursework.
Successful completion of business writing course

Responsibilities

Provides mentoring and support for Renewal Specialist staff.
Assists employees in the unit with technical questions.
Reviews, prioritizes, and assigns work coming into the unit.
Monitors completion of daily assignments to ensure timeliness.
Reviews work of employees within the unit to assist with coaching/mentoring.
Identify, coordinate, and communicate potential workflow and procedure changes with Quality and Workflow Team.
Orients new employees to the departmental and unit procedures.
Assist in establishment and monitoring of goals and objectives for the unit.
Audit and review work of employees within the unit.
Assists with the conducting of interviews and selection of employees.
Represents their respective unit in meetings regarding projects, processes, or issues.
Participates in on-the-job training of employees new to the role.
Complete system implementation impact lists as well as compliance updates
Respond to basic and complex policy inquiries and provide direct customer service to Agents by assisting with interpretation, application, and communication of rating algorithms, the policy contracts, workers compensation laws, Manual Rules Experience Rating calculations, Anniversary Rating Dates, and multiple and conflicting state factors/rules.
Calculates and determines renewal eligibility and insurability for policyholders.
Develops appropriate pricing based on loss history, audit results, STI, PM scores, and hazard exposures.
Approves or declines renewals for profitability and or/continuation of coverage using corporate underwriting guidelines within their Letter of Authority.
Recommends declinations to the BDC.
Evaluates group program renewals to incorporate proper placement of renewal accounts in or out of the program based on pricing needs, eligibility of the program, and loss history.
Reprice renewals due to competition, market fluctuations, multi-state repricing, or to retain profitability using in depth knowledge of each BDC’s repricing needs.
Evaluate by analyzing state rate reductions/increases to maintain profitability, add/remove schedule credit/debit, or move from one company tier to another.
Approves endorsement requests received from the service center and agents.
Reviews and evaluates inspection reports for policy changes requested from rating bureaus and/or state agencies.
Provides endorsement quotes to agents when requested.
Communicates with agency personnel on policy issues regarding reasons for non-renewals and cancellations.
Provides ad hoc mod promulgations for BDCs and agents.
Review AFXpress submissions for errors and to ensure they meet corporate underwriting guidelines.
Assist BDC’s in preparation for agency audits.
Serves as back-up to BDC’s for phone and e-mail inquiries regarding new and renewal business while BDC is out of office, including documentation of records and briefing BDC on any pertinent issues when they return.
Thoroughly assesses claim history of indemnity and medical claims.
Composes a summary of details relating to complex claims to add to the underwriting file.
Mentors Service Center employees.
Trains and mentors working out of class staff as well as new employees on the duties of the job.
Responds to basic and complex policy inquiries and provides customer service to agency staff.
Evaluates and determines governing class code changes due to audit findings or bureau inspection reports to properly class the policy holder based off their business operations.
Contact agency to notify of the changes in pricing or add credit to help offset any increased price as appropriate.
Work with agents to reallocate the payrolls if additional class codes are added to the policy.
Investigates and determines appropriate response to Independent Bureaus, NCCI, internal and external audit inquiries.
Provides technical support to agents with their online tools.
Thorough knowledge of multistate and regional needs, including appetite and complexities of the market.
Act as a subject matter expert for their assigned book of business.
Compose written correspondence to internal staff, agents, and policy holders.
Coordinates problem resolution and responds to customer complaints, errors, and service issues.
Makes appropriate decisions based on interpretation of policies and procedures.
Corrects policy structures based on audit findings to stay in compliance with Accident Fund’s and/or bureau rules and regulations.
Foster agency relationships by timely responses to renewal pricing and policy inquires.
Act as a back-up for the Large Account Coordinator as needed.
Works with minimum supervision