SUMMARY:



Responsible for underwriting review, analysis and eligibility verification of assigned risk applications. Maintain and process assigned policies throughout the life cycle including new and renewal policy issuance, renewal quotes, endorsements, reinstatements, cancellations, and certificates of insurance in accordance with State Plan rules and State regulations. Provide quality customer service to agencies and policyholders. Review and decipher reported payroll and tax documentation, and coverage and exemptions to rate and classify the risk to determine final audit premium in accordance with Manual rules and Plan requirements.



PRIMARY RESPONSIBILITIES:



Customer Service:


• Provide customer service and support to agency and policyholder customers as specified by Workers' Compensation Assigned Risk Plan.


• Respond to basic and complex policy inquiries and provide customer service to Policyholders and Agents by assisting with interpretation and understanding of rating algorithms, the policy contract, workers compensation laws, Experience Rating calculations, Anniversary Rating Dates and how the various state factors/rules work together on the same policy.


• Analyze Policyholder/Agent requests, research multiple state manuals and laws to advise acceptance or denial and/or coordinate the appropriate coverage/changes needed for a given exposure and obtain required documentation.


• Compose written responses to policyholder/agent requests, complaints and disputes with rational and relevant information in an effort to resolve and educate the employer and/or agent.


• Provide basic technical support to customers with their online tools.


• Process loss run requests.


Policy Management:


• Research business risk and history to verify eligibility of Plan coverage.


• Complete thorough underwriting review of the business risk and exposures to verify consistency and accuracy of the reported information to classify and develop payroll to compute adequate premium.


• Use of underwriting knowledge, experience and fraud indicators to identify premium avoidance and potential fraud.


• Manage and complete policy processing including policy issuance, quotes, endorsements, cancellations, reinstatements, compliance, certificates and final premium audits in accordance with the Performance Standards following Manual rules and state regulations.


• Evaluate incoming correspondence and process appropriate policy changes based on underwriting judgment, Plan and Manual rules, and state regulations.


• Use sound judgment to determine if an endorsement is necessary based on the latest audit information.


• Accept or deny request for cancellation and/or reinstatement and communication that decide to all authorized parties in accordance with the Performance Standards.


• Determine appropriate services to be offered to the employer based on policy exposure and history.


Policy Audit:


• Determine final audit type (Voluntary or Physical) based on underwriting judgment and Plan requirements.


• Analyze and decipher reported payroll and various tax forms, loss history, and risk and exposures to classify and develop payroll to determine audit premium in accordance with underwriting manuals and state regulations.


• Review and research various state web-site to determine exemptions.


• Determine inclusion or exclusion of payroll of employee and/or contracted services.


• Review and compare audit findings to current exposures to determine and make appropriate policy changes.


Accountability:


• Mentor and train underwriter new hires and assist with dispute resolution.


• Review and verify the accuracy of audits and endorsement for refund approval.


• Generate operational reports to monitor compliance with performance standards.


• Manage, track, and calculate retro adjustments as specified by the Plan.


• Manage and process complex policies.


• Respond and resolve difficult complaints and complex disputes.


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:




A. EDUCATION REQUIRED:



High school diploma or G.E.D with relevant course work (minimum 30 credit hours) in insurance, finance, business or a related field. Combinations of education and experience may be considered in lieu of credit hours.



B. EXPERIENCE REQUIRED:



One year experience as an Underwriting Technician I required.


OR


Two years experience in an underwriting environment and willingness to complete the formal Assigned Risk training program required.



C. SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:



• Knowledge of workers compensation industry.


• Basic knowledge of computers, word processing and spreadsheet software with accurate input ability of 40 wpm.


• Ability to proofread documents for accuracy of spelling, grammar, punctuation, and format.


• Math skills with the ability to use a ten-key adding machine.


• Thorough knowledge of tax forms, occupational classification codes, manual rules and servicing carrier standards related to workers compensation.


• Ability to provide excellent customer service and support to agency and policyholder customers as specified by Workers' Compensation Assigned Risk Plan.


• Demonstrated ability to make sound underwriting decisions.


• Thorough knowledge of appropriate jurisdictional workers compensation laws.


• Ability to comprehend the consequences of various situations and address them or refer them for appropriate decision making.


• Ability to effectively exchange information clearly and concisely, and present ideas, reports, facts and other information, and respond to questions as appropriate.


• Excellent time management and organizational skills with the ability to shift priorities appropriately.


• Strong analytical and problem solving skills.


• Excellent verbal and written communication skills with the ability to effectively communicate with agents, policyholders and internal customers.


• Ability to apply established underwriting guidelines, standards and regulatory requirements.


• Ability to assist management in the development and implementation of department goals.


• Knowledge of multi-line telephone system.


• Ability to process transactions on core processing systems.



D. ADDITIONAL EDUCATION, EXPERIENCE, SKILLS, KNOWLEDGE AND/OR ABILITIES PREFERRED:




WORKING CONDITIONS:



Work is performed in an office setting with no unusual hazards.



REQUIRED TESTING:



Basic Word, Basic Windows, Proofreading, Math, Basic Excel, 10-key, 40wpm