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Berkley Accident and Health is seeking a full-time Regional Sales Manager to develop profitable business initiatives in an assigned territory by devising detailed, focused sales plan to identify target markets needed to hit sales goals, directing distribution of Group Captive products in assigned region and any unassigned states through network of preferred producers, and creating new distribution outlets and facilitating marketing efforts to utilize alternative distribution methods; i.e. cross marketing through the Berkley family of companies, email blasts and newsletters, and attending industry events and seminars.
Regional Sales Manager essential duties include:
- Develop group captive program opportunities through credentialed broker partners
- Generate and facilitate pre-qualified submissions for all established programs through credentialed broker partrners
- Provide regular feedback to Home Office on successes and failures in the program and partner development process to allow for adjustments and improve close ratio
- Provide monthly updates on pipeline, current, and future activity
- Continue to expand product education and develop cross-selling opportunities within territory
- Be a proactive listener with customers by identifying needs and collaborating with Home Office to derive innovative solutions
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Stop Loss Account Manager Job Summary:
- Provide account support to customers, brokers and program sponsors for their captive program.
- Handle and manage day to day activity with stop loss accounts in assigned captive programs.
Stop Loss Account Manager Essential duties include:
- Preparation of EmCap Illustrations on an as needed basis.
- Manage all aspects of stop loss account activity post sale (new business and renewal) for an account including collection of outstanding requirements for policy issuance
- Schedule and conduct onboarding calls, when necessary to ensure a positive initial customer experience
- Establish account files through onboarding process, including contact information, EOR and reimbursement set up, updating the EmCap database, initiating reporting with TPAs, setting up commissions and assignment of account manager in DY (Sales Administrator)
- Initiate the collection of necessary data for underwriter to perform renewal underwriting, when requested.
- Client Service contact for management and oversight on employer client stop loss activity including claims payment inquiries, premium submissions, commissions and overrides. Identify and resolve any issues that come up in these areas.
- Review A/R reporting monthly, pursue any overdue premiums and work with Premium Collection team to ensure that all shortfalls or overpayments are resolved satisfactorily. When necessary, prepare reconciliations to resolve discrepancies in premium payments.
- Upon request, prepare Schedule A – Form 5500 requests for information.
- Review commission payment summaries monthly for accuracy and take any remediation on a timely basis to ensure that incorrect payments are minimized.
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The Clinical Risk Analyst (CRA) role is an integral part of our Clinical Risk Management team. Our CRAs provide organized, timely, and effective management of all notifications for Berkley Accident and Health's (BAH) Employer Stop Loss (Direct and Captive) and Managed Care business lines. Our CRAs support Berkley Accident and Health's vision of being recognized as an industry leader in risk management services.
Clinical Risk Analyst I Essential Responsibilities:
- Adopts BAH core competencies in personal work behaviors, decision-making, contributions, and interpersonal interactions.
- Develops relationships with our Clinical Risk Management team members, other BAH employees and external clients to further BAH's mission.
- Facilitates timely and accurate intake, screening, triaging, tracking and maintenance of all potential claim notifications and associated reports/documentation.
- Assists in maintaining accurate database tracking and reporting.
- Demonstrates a solid work ethic and maintain a positive attitude.
- Develops compliance with all company and department policies and procedures, quality assurance programs and service level agreement standards.
- Works with other team members to coordinate the management of shared e-mail box (es).
- Provides excellent customer service / communications by responding in a timely and appropriate manner to all internal and external customers.
- Other duties as may be assigned.
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Berkley Accident and Health is seeking a full time Underwriter for its Managed Care segment. This position will solicit, write and retain a profitable book of Managed Care/Reinsurance business. Requiring extensive underwriting analysis and sound judgment, this role will be responsible for contributing to the achievement of Berkley Accident & Health’s financial plans by meeting established premium growth and profitability goals.
Managed Care Underwriter Essential duties include:
- Assess risk to ensure that the risk meets established underwriting criteria
- Evaluate, price and propose rates based on established underwriting guidelines while meeting profitability standards set by Management.
- Manage assigned workload to meet productivity and time service standards.
- Maintain quote logs and ensure that appropriate action is taken within the requested due date.
- Develop and maintain successful relationships with target sources.
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Job Summary
Conduct a review of all Managed Care claims processed by our contracted vendor. This role will require communication with that vendor as appropriate, as well as any internal Berkley staff involved in the administration of the Managed Care segment.
Job Responsibilities
- Review claims payment results performed by contracted vendor on all Provider Excess and HMO Reinsurance business and provide policy documentation, disclosure, risk matrixes and DOFRS to them upon request and within approved authority limits.
- Communicate with contracted vendor as appropriate and respond to client and broker inquiries, as necessary.
- Elevates issues to next level of supervision, as appropriate.
- Manage workload to meet time service standards.
- Exhibit good organizational, oral communication and interpersonal skills while working with internal and external customers.
- Document outcome of claim reviews in the shared drive, as appropriate.
- Utilize knowledge of regulatory/statutory guidelines including but not limited to, HIPPA, privacy, Affordable Care Act, etc., as appropriate.
- Other duties as assigned.
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Berkley Accident and Health is seeking a full time Stop Loss Underwriter for our Group Captive division. This position will write and retain profitable accounts that require underwriting experience, with an analytic approach to spread risk. This role will contribute to the achievement of Berkley’s financial plans by meeting premium growth and profitability of assigned book of business.
Stop Loss Underwriter, Captives Segment – Essential duties include:
• Underwrites and proposes financial structure on accounts from 50 – 400 employees within delegated authorities that are specific to position.
• Responsible for constant analysis and development of underwriting and business guidelines
• Develops and maintains successful relationships with target sources and assigned programs
• Responsible for ensuring profitability at both the single employer and group captive level
• Manages an assigned volume of case and program activity for both new and renewal policies
• Works with Supervisor and Actuary to revise and develop group captive tools to improve efficiencies in underwriting process.
• Communicates effectively with various team members within Captive Division
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This role requires relocation to either Hamilton Square, NJ or Marlboro, MA
The Underwriting Leader is a seasoned medical stop loss underwriting professional who has the years of experience and knowledge to manage a staff of underwriters, as well as exercise sound judgment to achieve appropriate risk adjusted rates of return. In this role you will be a member of the Captives Executive Team; you will collaborate with Captives SVP, Distribution, and Program teams to efficiently manage the quote, negotiation and underwriting activity for our various medical stop loss group captive programs. The role requires the ability to manage a staff of underwriters including workload assignments, personnel and performance reviews, training, and overall strategic guidance. Leader is expected to analyze both financial and clinical risk contingencies, understand the unique risk management initiatives within each programs, and develop rating strategies accordingly.
Captives Underwriting Leader Essential Duties include:
• Collaborate with Senior VP to achieve product financial targets, produce department KPIs, and participate in overall product strategic development.
• Work with Business Development team to ensure deadlines are met.
• Travel with Business Development and Program Management teams to meet with producers and program members.
• Oversee the activity assignments and workload balance of staff of UWs
• Assume an actual assigned workload as appropriate
• Support staff on challenging risk evaluations, service situations, and during periods of high activity
• Ensure staff is properly composing, preparing, and generating correspondence, proposals, and other reports as needed or required.
• Ensure staff is conducting clinical risk evaluations utilizing available resources.
• Make pricing recommendations that will lead to acceptable risk adjusted returns.
• Evaluate and propose pricing on Stop Loss business within stated authority limits.
• Oversee the review of Applications, Policies, Plan Documents/Amendments, and Proposal Contingencies ensuring that they are complete, accurate and in accordance with the sold case terms.
• Ensure that staff is digging in on all data points and analyzing all submitted data from production source.
• Prepare detailed referral recommendations beyond authority limits to SVP that include historical and proposed ESL terms, clinical diagnosis, and paid claims to properly evaluate risk with recommendations on rates, lasers and other contingencies.
• Develop a comprehensive understanding of terms and conditions relative to each EmCap program.