Lead Worker Specialty Billing
AF Group

Lansing, Michigan

Posted in IT


This job has expired.

Job Info


SUMMARY:

In addition to fulfilling the primary responsibilities of the Specialty Billing Representative I & II, this role will also focus on serving as a lead worker in the Service Center by assisting staff with technical questions and provide mentoring to current and new staff. This role will also serve as a Subject Matter Expert, assisting with billing, commission and collections related issues as well as participating in enterprise projects.

PRIMARY RESPONSIBILITIES:

  • Provides mentoring and support for Service Center staff
  • Assists employees in the unit with technical questions.
  • Reviews, prioritizes, and assigns work coming in to the unit.
  • Monitors completion of daily assignments to ensure timeliness.
  • Reviews work of employees within the unit to assist with coaching/mentoring
  • Identify, coordinate, and communicate potential workflow and procedure changes with Quality and Workflow Team
  • Orients new employees to the departmental and unit procedures.
  • Assist in establishment and monitoring of goals and objectives for the unit.
  • Audit and review work of employees within the unit.
  • Assists with the conducting of interviews and selection of employees.
  • Facilitates, researches, and resolves complex internal and external customer inquiries through verbal or written communication.
  • Collaborates with other roles/departments for items that require special handling and/or additional research.
  • Backup for ACD calls in the respective unit.
  • Edits and updates billing documents on an as needed basis as well and reviews system inputs for accuracy. Serve as a Subject Matter Expert regarding policy and billing issues and projects/issues.
  • Represents their respective unit in meetings regarding projects, processes, or issues.
  • Participates in on-the-job training of employees new to the role.
  • Collaborates with Quality and Workflow Team in maintaining department procedures, work instructions, and job aides; may participate in initiating new workflows or workflow changes.
  • Maintains in-depth knowledge of policy and commission structure of each brand within the Enterprise.
  • Completes manual commission calculations for the individual brands within the Enterprise. Creates statements and check requests to pay commissions on a monthly basis.
  • Manually calculates and bills for retrospective premium adjustments and monthly losses related to loss sensitive business for all brands within the Enterprise.
  • Monitors and tracks collateral to ensure loss funds are adequately funded.
  • Works directly with policyholders and external collection agencies in regards to past due balances. Uses authority levels to make decisions in regards to balances due.
  • Monitors aging reports and completes follow-ups with Premium Audit, Underwriting and Management.
  • Reviews, negotiates and approves payment arrangements and settlement offers on past due receivables for the Enterprise.
  • Files bankruptcy claims with the Bankruptcy Court for policyholders that have entered bankruptcy. Has an understanding of the different types of bankruptcy and how to appropriately handle each.
  • Participates in the development of requirements related to new Enterprise-wide systems.
  • Verifies reasonableness of data in ancillary and disparate systems.
  • Reconciles accounts to clarify billing transactions and cash application in order to provide customers with up-to-date account information/history.
  • Responds to internal and external customer requests via telephone or electronic correspondence. Correspondence is drafted as requested to address complaints or information requests. Requests are initiated by agents, policyholders, underwriters, or management.
  • Processes pay by phone transactions to expedite posting of cash to insured's policy.
  • Requests write offs to resolve small balance and NSF fee discrepancies within guidelines.
  • Requests money moves to ensure accurate posting of cash.
  • Maintains knowledge of state regulations as they pertain to movement of funds between policies and legal entities.
  • Maintains confidentiality of information processed
  • Provides coverage and assistance across all primary responsibilities and focus areas.
  • Addresses and responds to complex internal and external customer requests.
This description identifies the responsibilities typically associated with the performance of the job. The percentage of time in any responsibility may vary between positions. Other relevant essential functions may be required.

EMPLOYMENT QUALIFICATIONS:
  • EDUCATION REQUIRED:

  • Minimum of an Associates degree in business, insurance, or related field. Combinations of relevant education and work experience may be considered in lieu of formal education.

  • EXPERIENCE REQUIRED:

  • Minimum of five (5) years experience in billing, underwriting, policy processing or equivalent work which provides the necessary skills, knowledge and abilities. One (1) year as a Specialty Billing Representative II.

    OR

    Bachelor's degree in Business and three (3) years of relevant experience in billing, underwriting or policy processing.
  • SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:
    • Ability to objectively review the work of others to ensure quality output.
    • Knowledge of Workers Compensation or insurance.
    • Ability to train and coach others to perform the core responsibilities.
    • Knowledge of claims and underwriting operations (i.e. deductibles, billing etc.,)
    • Ability to analyze details of policy billing and payment data and, based on this analysis, make efficient and effective independent decisions within authority.
    • Ability to analyze details of policy billing and payment data and, based on this analysis, make efficient and effective independent decisions within authority.
    • Ability to manage multiple priorities and meet established deadlines.
    • Ability to proofread documents for accuracy of spelling, grammar, punctuation, and format.
    • Knowledge of insurance operations, specifically as they pertain to state specific requirements.
    • Excellent math skills. Ability to accurately interpret and analyze data.
    • Ability to process transactions on multiple processing systems.
    • Ability to use diplomacy, discretion and appropriate judgment when addressing callers.
    • Ability to proofread documents for accuracy of calculations.
    • Excellent organizational skills and ability to prioritize work in order to meet strict deadlines.
    • Excellent oral and written communication skills.
    • Excellent analytical and problem solving skills.
    • Knowledge of computers and ability to type 40 words per minute.
    • Knowledge of word processing software.
    • Basic knowledge of database software.
    • Advanced knowledge of spreadsheet software.
    • Ability to effectively exchange information clearly and concisely, reports facts and other information and respond to questions as appropriate.
    • Knowledge of policy and claim processing systems.
    • Knowledge of enterprise policy and commission structure.
    • In-depth understanding of collateral structures and plans.
    • Ability to interpret, analyze and bill a policy with minimal supervision.
    • Knowledge of state specific collection regulations and laws.
    • Knowledge of loss sensitive plans used by the enterprise; specifically, how balances related to losses are calculated and invoiced.
    • Knowledge and understanding of both underwriting and claims is obtained
    • In-depth knowledge of insurance operations. Specifically as they pertain to state specific requirements.
    • Demonstrated knowledge to provide coverage and assistance across all primary responsibilities referenced above.
    • Ability to make decisions and work with minimal supervision.
    • Ability to manage multiple priorities and meet established deadlines.

  • ADDITIONAL EDUCATION, EXPERIENCE, SKILLS, KNOWLEDGE AND/OR ABILITIES PREFERRED:
    • Bachelor's degree in business, insurance, or related field.
    • Progress towards or successful completion of the CAWC program.
    • Insurance Institute of America (IIA) or other insurance related coursework.
    • Knowledge of departmental procedures, workflows, and systems.
    • Knowledge and experience of policy processing, claim and financial reporting systems.

    WORKING CONDITIONS:

    Work is performed in an office setting with no unusual hazards. Work may be performed at varied hours/days/shifts.

    REQUIRED TESTING:

    Math, Typing 40wpm, Intermediate Word, Advanced Excel, Basic Access, Intermediate Windows, Proofreading, Reading Comprehension.


    This job has expired.

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