Underwriting Technical Specialist I/II

Blue Cross Blue Shield of Michigan•Lansing, MI

About The Position

Primarily responsible for customer service and underwriting technical support for agencies and policyholders on underwriting rules, procedures, regulations, policies, and audit information. The role reviews and approves or declines endorsement requests, responds to bureau criticisms, verifies coverage, completes experience rating promulgations or Loss Pricing & Projection Models, and mentors colleagues on basic questions and policy information. Contacts include state rating bureaus and internal departments, agents, and policyholders. The position interprets and applies rating algorithms, policy contracts, workers’ compensation laws, manual rules, and experience rating calculations. It analyzes requests and researches state manuals and laws to determine appropriate coverage changes and required documentation. It reviews policy structures, endorsements, amendments, audit findings, and bureau inquiries; coordinates policy corrections or cancellations; and resolves customer complaints, errors, service issues, and policy change requests. The role manages individual and team workflow inventories, supports agents’ online tools, trains agents and agency employees on company systems, and may train and mentor Underwriting Technical Specialist I employees. The description includes additional responsibilities and qualifications for the CSR II level. Work is performed in an office setting with no unusual hazards. The description states that relevant combinations of education and experience may be considered in lieu of a degree.

Requirements

Associate degree in business, insurance, or a related field, with progress toward or completion of an Insurance Institute of America (IIA) or other insurance-related designation; relevant combinations of education and experience may substitute for a degree.
One of the stated experience pathways: two years with Accident Fund Insurance Company of America as a Policy Processing Representative II or Customer Billing Representative; or a bachelor’s degree in business, insurance, or a related field with progress toward or completion of an insurance-related designation, plus two years of relevant underwriting, bureau, policy, audit, endorsement, or premium-billing/customer-service experience.
One year of technical or administrative office experience, including relevant underwriting duties in an insurance organization or legal duties, or three years of the necessary skills, knowledge, and abilities, may be considered.
For CSR II: one year as an Underwriting Technical Specialist I with demonstrated technical decision-making, policy-contract interpretation, and underwriting knowledge, plus experience applying manual rules across multiple states and regulatory authorities; alternatively, the stated bachelor’s-degree pathway requires three years of relevant underwriting, bureau, policy, audit, endorsement, or premium-billing/customer-service experience.
Ability to work effectively in a multifunctional, multistate business unit.
Knowledge of state-specific underwriting and audit rules, procedures, and workers’ compensation classifications in multiple states.
Knowledge of workers’ compensation underwriting terminology and concepts.
Excellent interpersonal, verbal, and written communication skills, including the ability to interpret and explain policy contract language.
Knowledge of eLink or another agency rating tool and online portals.
Strong organizational skills, ability to prioritize multiple tasks, and ability to meet deadlines with minimal supervision.
Computer and spreadsheet skills, accurate data entry at 40 wpm, and basic word-processing knowledge.
Strong analytical and problem-solving skills.
Knowledge of a multiline telephone system and ability to process transactions on core processing systems.
Ability to proofread documents for spelling, grammar, punctuation, and format.
Math skills and ability to use a ten-key adding machine.
For CSR II: ability to recognize and negotiate solutions for unique requests; knowledge of state-specific underwriting and audit rules and concepts, workers’ compensation classifications and procedures, and manual rules across core and non-core states and regulatory authorities; ability to think proactively and independently; demonstrated technical knowledge of policy exposures and the implications of changes; and knowledge of Accident Fund, 3CU, and CompWest products and services.

Nice To Haves

Successful completion of a business writing course.

Responsibilities

Respond to basic and complex policy inquiries and provide customer service and technical support to agents and policyholders.
Interpret, apply, and explain rating algorithms, policy contracts, workers’ compensation laws, manual rules, experience rating calculations, anniversary rating dates, and state-specific factors and rules.
Analyze agent requests, research state manuals and laws, advise on or coordinate appropriate coverage changes, and obtain required documentation.
Review and approve or decline endorsement requests, including requests involving states, named insureds, entities, locations, ownership, payroll, class codes, credits, waivers of subrogation, wrap-ups, alternate employers, IDs, officers, payment plans, and cancellations.
Analyze policy structures, endorsements, and amendments and research state and rating bureau resources to verify coverage for entities or locations.
Provide basic technical support to agents using online tools and train new agents and agency employees on company automation systems.
Research and coordinate resolution of complaints, errors, and service issues involving agents, policyholders, and regulatory entities.
Work with internal departments to resolve problems and maintain company relations.
Make decisions based on interpretation of policies and procedures; investigate and respond to bureau, NCCI, and internal and external audit inquiries.
Negotiate and direct action to resolve policy change and bureau requests.
Manage individual and team workflow inventories within Notes & Tickets to meet service-time goals.
Research and analyze policyholder financial, safety, loss, and payroll history for multiple operating units.
Analyze past losses and payroll data to determine modification-factor variances or enter data for updated-factor or Loss Pricing & Projection calculations.
Compose written correspondence for internal and external customers as needed.
Review audit findings, determine whether policy changes are needed, coordinate with agents to obtain documentation, and correct policy structures or cancel coverage as appropriate.
Identify solutions for multiple or cross-functional business areas and assess the impact of industry direction.
Determine promptly which policies require further review and coordinate resolution with internal departments and agency staff.
Identify changes in risk exposure or desirability resulting from endorsement requests or audit findings.
Train and mentor Underwriting Technical Specialist I employees.
For CSR II, recognize and negotiate solutions for unique requests and address customer needs proactively with a long-term perspective.