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Some responsibilities include:

Role Summary:

In the Premium Analyst II role, you will be responsible for providing world class customer service to our clients. You will interact regularly with internal and external customers and partners as it relates to client invoicing, account reconciliation and collections. This role requires analyzing complex client data to reconcile and resolve discrepancies.

Responsibilities/Core functions:

• Manage assigned portfolio of complex client accounts
• Perform tasks related to collections processes and procedures
• Perform tasks related to review of client AR for preparation of necessary adjustments/disbursements to submit to processing team
• Research/respond to billing or payment inquiries within established turnaround times. Escalate issues as needed.
• Work with third party administrators, brokers and/or clients directly to reconcile accounts receivable
• Facilitates conference calls or meetings with internal and external parties
• Extensive research related to member eligibility and rate variances
• Prepare necessary adjustments to resolve member level discrepancies identified in reconciliation process
• Build effective relationships with internal and external partners
• Handle special billing or report requests
• Analyze client data utilizing various reports and resources
• Prepare and distribute Schedule A & C tax forms
• Coordinate various activities to ensure compliance with tax regulations

Billing Specialist (Band 2)

Responsibilities/Core functions:

– Manage the day to day Billing schedule and work with internal partners to ensure all groups are invoiced in accordance with their pre-established invoicing schedule
-Work with internal partners to provide pre-bills for groups who are being implemented or experiencing a rate change as part of the Renewal/ Maintenance process
-Work with the Premium Team and Benefits Teams each month to ensure that group cancellations are processed within the appropriate timeframe
-Place bills on hold upon request and actively follow up with internal partners until the bills are released
-Responsible for the daily maintenance of the Analyst Listing on SharePoint as well as ARCUS
-Work with other internal partners to facilitate the testing for invoice enhancements or template changes (please note, that this may involve occasional after hours production check-outs)
-Ensure that all invoices are successfully dispatched systematically and work with IT to trouble-shoot any invoices whose dispatch may have failed
-Distribute returned hard copy invoices to the Premium Team on a regular basis
-Manage the billing inbox and all requests that are received on a daily basis
-Prepare and deliver pre-established Billing reports for internal partners each month

The Property Major Case Claim Specialist is a PMC entry level role. In this position, the Claim Specialist will allocate time between duties that include review and triage of direct escalations and referrals into Property Major Case and the adjustment of property claims with values in excess of $100,000. Claim inventory will consist of I/A oversight as well as full file handling of claims requiring on-site inspections. This position is designed as the intermediary step between Outside Claim Representative or Senior Claim Representative and Associate General Adjuster.

Key responsibilities include:

++ Accurate and timely review and triage of incoming direct claim escalations and claim referrals.

++ Accurate and consistent maintenance of established records regarding disposition of referrals.

++ Establish and maintain a positive working relationship with CCT and Property Centers.

++ Accurately interpret the insurance contract and apply the exposures of the claim to fulfill our contractual obligations to the policyholder.

++ Properly investigate all exposures and/or perils to determine cause, scope, and cost of damage and/or determine liability and extent of damages, including the identification and investigation of subrogation opportunities.

++ Ensure compliance with state statutory requirements and good faith claim handling.

++ Conduct investigation to determine the extent of exposure for purposes of reserving and ultimate payment.

++ Efficiently and effectively document all claim activity to support the outcome of the claim file. Comply with all internal and external reporting requirements.

++ Identify predictive indicators of fraud, perform background checks, coordinate with special investigators, report to external agencies and bureaus, and assist in identification of trends, perpetrators and patterns of suspicious or fraudulent activity.

++ Identify subrogation and salvage opportunities and partner with internal or external business partners to secure maximum recovery.

++ Utilizes thorough cost benefit analysis in the selection and management of vendors

++ Demonstrates expense discipline in incurring and paying expenses.

++ Guide policyholder through the claim process to ensure understanding

++ Overnight travel maybe required