SUMMARY:
Primarily responsible for providing customer service and underwriting technical support to agencies and policyholders related to underwriting rules, procedures and regulations, policy, and audit information. Reviews & approves/declines endorsement requests and responds to bureau criticisms to maintain policies and stay in compliance with Accident Fund’s and bureau rules and regulations. Verifies coverage for current policy and/or additional named insureds/DBA’s/locations. Completion of experience rating promulgations or Loss Pricing & Projection Model. Mentors PPRs & CBR’s with basic questions and policy information. Contacts include state rating bureaus, Service Center staff, Business Development Consultants, Business Development Managers, Corporate Underwriting, Finance Department, Claims Department, agents, and policyholders.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.
- Respond to basic policy inquiries and provide direct customer service to Agents. 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 .
- Analyze Agent requests, research multiple state manuals and laws to advise and/or coordinate the appropriate coverage/changes needed for a given exposure and obtain required documentation. Review and approve/decline endorsement requests that include, but are not limited to adding/removing a new state/name/entity/location, changes in ownership, payroll, class codes, credits, Waivers of Subrogation, Wrap-up/OCIP/CCIP, Alternate Employer, Federal/Risk IDs, Officers, payment plans, and policy cancellation.
- Analyzes policy structure, endorsements, and amendments as well as research State & Rating Bureau web sites to verify coverage for an entity or location for internal departments.
- Provide basic technical support to agents with their online tools.
- Trains new agents and new agency employees on the use of company specific automation systems. Research and coordinate problem resolution and direct responses to agents, policyholders and regulatory entities regarding customer complaints, errors, and service issues.
- Explains and emphasizes benefit of workers’ compensation insurance products and services to customers.
- Works with internal departments to resolve problems and maintain company relations. Make appropriate decisions based on interpretation of policies and procedures.
- Investigate and determine appropriate response to Bureau, NCCI, internal and external audit inquiries.
- Negotiate and direct action for resolution to policy change requests and bureau requests.
- Manage individual workflow inventory within Notes & Tickets to achieve specific time service goals.
- Research and analyze history of policyholder (i.e. financial, safety, loss experience, & payrolls) for multiple operating units.
- Analyze past losses and payroll data to determine variances of a modification factor or enter into a database for calculation of an updated factor or Loss Pricing & Projection.
- Compose written correspondence, as needed, with internal and external customers.
- Reviews audit findings to determine if retroactive or current changes need to be made to policy and coordinate with agent to obtain necessary documentation.
07/17 Re-allocatable
- Correct policy structures or cancels coverage based on audit findings in order to stay in compliance with Company’s and/or bureau rules and regulations.
Additional for CSR II:
- Actively engages in the identification of solutions for multiple or cross-functional business areas. Has an understanding of the direction of the overall industry and evaluates the related impact.
- Evaluate and decide in a timely manner which policies require further review and coordinate resolution with internal departments and agency staff.
- 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.
- Identifies impacts to exposure that may change desirability of risk as it relates to endorsement requests and/or audit findings.
- Manage team workflow inventory within Notes & Tickets to achieve specific time service goals.
- Train and mentor Underwriting Technical Specialist I’s.
EDUCATION AND EXPERIENCE
Relevant combination of education and experience may be considered in lieu of degree.
A. EDUCATION REQUIRED:
Associate degree in business, insurance or related field with progress toward or completion of Insurance Institute of America (IIA) or other insurance related designation(s). Combinations of education and experience may be considered in lieu of a degree.
B. EXPERIENCE REQUIRED:
Two (2) years' experience with Accident Fund Insurance Company of America as a Policy Processing Representative II or Customer Billing Representative.
OR
Bachelor’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
Two years' 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.
And
One year 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 for the position, may be considered.
Additional Experience required for CSR II:
One year as a Underwriting Technical Specialist I with demonstrated technical decision making and interpretation of policy contract language and underwriting knowledge.
07/17 Re-allocatable
Experience with interpretation of and application of manual rules across multiple states and regulatory authorities.
OR
Bachelor’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 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.
And
One year 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 for the position, may be considered.
QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
C.OTHER SKILLS AND ABILITIES
- Ability to work effectively in a multi-functional and multi state 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 and ability to interpret and explain policy contract language. Knowledge of eLink or other agency rating tool and online portals. Excellent organizational skills and ability to prioritize work.
- Ability to manage multiple priorities and meet established deadlines.
- Ability to work with minimal supervision.
- Knowledge of computers and spreadsheet software with accurate input ability of 40 wpm.
- Basic knowledge of word processing.
- 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.
Additional SKA’s for CSR II:
- 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.
- Knowledge of Accident Fund/3CU/CompWest products and services.
07/17 Re-allocatable
D.
ADDITIONAL EDUCATION, EXPERIENCE, SKILLS, KNOWLEDGE AND/OR ABILITIES PREFERRED:
- Successful completion of business writing course
WORKING CONDITIONS:
Work is performed in an office setting with no unusual hazards.
ADDITIONAL INFORMATION
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. This job description does not constitute a contract for employment.
