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Member Services Insurance Specialist
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State Employees Association of North Carolina
Raleigh, NC (In Person)
$46,075 Salary, Full-Time
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Job Description
Member Services Insurance Specialist
JOB SUMMARY
The Member Service Insurance Specialist performs a wide variety of skilled duties for the Insurance Division of the Member Services Department. Work requires tact and diplomacy in public contact, as well as ability to process necessary information in a timely manner.RESPONSIBILITES
- Performs on-going evaluation of the process, procedures, and workload; makes and recommends changes to the Director of Member Services to achieve the most efficient and timely completion of work to ensure work is processed within timeframes required to meet deadlines.
- Serves as a point of contact for members, potential members, insurance companies, deceased member's families and beneficiaries, the districts, and the Insurance Board of Trustees.
- Serves as secretary and staff liaison in conjunction with the Director of Member Services to the Insurance Board of Trustees and Board Chairperson.
- Receives applications and payments for insurance programs
- Processes and codes applications that automatically qualify for coverage.
- Enter or correct personal and related data as needed.
- Prepares and mails all insurance certificates monthly.
- Handles public inquiries on types of insurance programs and premiums, eligibility, payments, and a wide variety of technical insurance policy provisions related questions.
- Mails information as requested.
- Contacts insurance companies for interpretation to assist members.
- Sells insurance products to members, requiring insurance licensing.
- Processes death claims correspond with insured or beneficiaries and /or requests death certificate, court papers or autopsy reports depending on situation to obtain required information; forwards appropriate forms to insurance companies; forwards any over payments of premium to beneficiaries as needed.
- Handles correspondence with insured via phone, email, and online chat; obtains information for changes and/or responds to questions or problems.
- Handles public inquiries and concerns about membership or insurance records and resolves problems regarding these records.
- Acts as a liaison between members and insurance providers on escalated billing and claim related issues.
- Prepares individual billings as needed.
- Performs pay histories as needed regarding providing information for refunds.
- Prepares and reviews insurance delinquent list for members that are delinquent in their insurance plan.
- Data entry
- Deletes cancellations at member's request or for non-payment.
- Processes credit card payments for delinquent dues and insurance payments.
- Scanning and indexing member data into a data management system daily.
- Provides
- Performs related duties as required and as assigned.
- Performs related duties as required involving the security and privacy related to membership and insurance records and data files.
- Perform special projects as requested by the Director of Member Services.
QUALIFICATIONS
- Graduation from a two-year business school and two years of clerical experience in processing records and handling funds or graduation from high school with four years of clerical experience in processing records and handling funds. An equivalent combination of education and experience will be considered.
- Life and Insurance Agent Certification by the North Carolina Department of Insurance required.
- Considerable knowledge of North Carolina's life and health insurance laws and guidelines.
- Considerable knowledge of records systems, processing, and maintenance on an automated system.
- Ability to work independently
- Considerable knowledge of administrative practices and procedures.
- Ability to perform accounting related work, balance workload priorities and to meet required deadlines.
- Ability to evaluate operations processes and recommend changes for implementation that improve efficiency and effectiveness.
- Ability to communicate effectively and professionally in oral and written forms.
- Ability to use sound judgment in handling problem inquiries and resolving them in a timely manner.
- Ability to use computer and related office equipment.
- Ability to handle correspondence independently and adhere to good grammar and punctuation.
- Ability to process records accurately and with considerable speed to maintain the records on a current basis.
- Ability to establish and maintain effective working relationships with members, insurance companies, insurance companies, insured and beneficiaries, employees, superiors, court and state officials.
PHYSICAL REQUIREMENTS
- Must be able to physically perform the basic life operational functions of kneeling, reaching, pulling, pushing, lifting, repetitive keyboard activity, talking, hearing, and repetitive motions.
- Must be able to perform light work exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force frequently or constantly to lift and move objects.
- Must possess the visual acuity to work with data and figures, to perform accounting tasks, to operate a computer terminal, and to check work for accuracy and thoroughness.