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The Finance Services Specialist is responsible for understanding policy and claim systems and processes as they relate to Finance, in order to address client and internal inquiries, in particular to premium and deductible billings.
Responsibilities include but are not limited to the following:
- Maintain current receivable aging reports and undertake action plans for collecting past due balances, in accordance with Company policy
- Post refund and subrogation reimbursements to the claim system
- Assist with deductible billings and inquiries
- Function as the primary backup resource for processing and billing reporting-based payrolls and responding to related client inquiries, as part of the Finance client service team
- Maintain written policies and procedures for these functions
- Work effectively with team members and management to achieve continuous process improvement, strengthen internal controls and promote a collaborative work environment
Key Risk is looking for an enthusiastic and experienced underwriter to join our team. The successful candidate will be responsible for contributing to achieving and exceeding the regions’ profit plan through proper risk selection, agency management, and communication of Key Risk’s value proposition.
Key functions and responsibilities include, but are not limited to the following:
- Underwrites accounts up to $750,000 annual premium
- Manage a book of business $5,000,000 to $7,000,000
- Develops and maintains relationships with 10-15 agencies
- Responsible for a moderate number of agencies including partners with Advantage and/or Premier status within our Key Alliance agency structure
- Achieves/exceeds planned accident year loss ratio, rate change, renewal retention and inforce premium goals
- Takes initiative to recommend potential improvements in underwriting principles, techniques or appetite
- Complies with insurance filings and regulatory requirements
- Research new market niches, serve as an industry lead, and participate in special projects
- Establishes a knowledge base of agency needs, staff, target markets, and contracted insurers
- Performs agency evaluations and establishes agency goals within required time frames and expectations
- Participates effectively in new and renewal team sales activities and Client Service Management (CSM) meetings to obtain and retain profitable business
The Claims Professional is responsible for the analysis and management of workers’ compensation claims for assigned clients, including minor and complex claims. This position will review, investigate, and make decisions regarding coverage, compensability, and appropriateness of claims. The position will process and document claims to ensure compliance with company standards, industry best practices, and legislative provisions. Acts in a fiduciary role on behalf of policyholders and negotiates claim settlements. Claims Professionals conduct the handling of claims in the utmost of good faith in compliance with the rules, regulations and state statutes. Experience and the degree to which a claim professional can work independently to make sound decisions, reserve recommendations and drive outcomes will determine the hiring position, ranging from a Claim Representative I to a Senior Claim Representative. The Claims Professional is expected to function with a high degree of competency and independence. The use of sound judgment coupled with strong technical claim handling skills and consistent results are expected.
Key responsibilities include but are not limited to:
- Analyzes and processes workers’ compensation claims by investigating and gathering information to determine the exposure on the claim.
- Negotiate settlement of claims up to designated authority level and makes claims payments.
- Calculates and assigns timely appropriate reserves to claims and continues to manage reserve adequacy throughout the life of the claim.
- Calculates and pays benefits due; approves all claim payments; and settles claims within designated authority level.
- Develops and manages claims though well-developed action plans; continues to work the action plan to bring the claim to an appropriate and timely resolution.
- Prepares necessary state filings within statutory limits.
- Actively manages the litigation process; ensures timely and cost-effective claims resolution.
- Coordinates vendor referrals for additional investigation and/or litigation management.
- Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims.
- Frequently communicates with all appropriate parties involved with the claim.
- Maintains professional client relationships.
- Actively executes appropriate claims activities to ensure consistent delivery of quality claims services.
Key Risk is looking for an enthusiastic professional who will be responsible for the management of low exposure workers’ compensation claims. The Claims Associate will be responsible for learning workers compensation laws and providing outstanding service to our clients. This is an entry-level position with no experience necessary.
- Maintain good lines of communication with employers, adjusters, and providers
- Conduct investigation of workers' compensation claims assigned
- Request medical notes, proper billing format, and other written/verbal information from employers and medical providers to determine appropriateness of payment of medical bills and whether a claim is truly medical only
- Discuss with an employee, issues relative to whether a bill has been paid or whether travel or medical reimbursement has been issued
- Timely and accurately reserve for claims assigned
- Document medical notes and relevant written and oral communication received relative to claims in the log notes
- Discuss with an employer, issues relative to an injured workers’ return to work status
- Index images as needed
- Identify potential subrogation claims and notify appropriate supervisor
- Actively work with mentor and supervisor to develop skills to handle all technical aspects of claims, including coverage, disability benefit management, medical management, litigation management, file management, subrogation, reserving and settlement
- Maintain and demonstrate knowledge of the Workers' Compensation Act and Rules and Regulations in jurisdictions assigned
- Immediately notify management of large exposures
- BA/BS Degree
The PEO Specialty Underwriter solicits, writes and retains profitable PEO accounts that require an in-depth underwriting analysis and sound judgment. The position markets Key Risk specialty products and services to the agents and participates in agency management process.
- Underwrites new and renewal PEO accounts
- Documents analyses and decisions with adequate detail using the Key Risk documentation tools
- Takes the initiative to recommend any improvements in underwriting principles, techniques or appetite when they become apparent
- Achieves planned premium, rate change and loss ratio goals
- Participates with Area Vice President or Director of Underwriting in agency, account visits and industry events to sell products and services and ensure flow of target submissions
- Contributes to agency evaluations, goal settings and development plans
- Assists Director of Underwriting with research and development projects as requested
- Assists other areas of the company with the acquisition and servicing of our policyholders.