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INSURANCE INVESTIGATOR I/II/III, APPEALS and GRIEVANCES

Recruitment #19-009638-0004

Introduction

The Maryland Insurance Administration (MIA) is an independent State agency that regulates Maryland’s insurance industry and protects consumers by monitoring and enforcing insurers’ and insurance professionals’ compliance with State law.  Through the diligence of a highly professional staff of market analysts, financial analysts, accountants, lawyers, law enforcement officers, actuaries, complaint investigators, and others, the MIA works to facilitate a strong and competitive insurance marketplace where consumers are well informed and treated fairly.  Staff members are subject matter experts who serve as a resource for lawmakers, consumers, and other public and private entities.  

 
The MIA is charged with a broad range of responsibilities including the licensure of insurance carriers and insurance producers (brokers/agents) operating in Maryland, the conduct of financial examinations of companies to monitor financial solvency, and the review and approval of rates and contract forms.  The MIA investigates reports of consumer fraud and consumer complaints about life, health, automobile, homeowners, and/or property insurance.  Insurance carriers are subject to market conduct examinations and other actions to monitor compliance with Maryland law.  The MIA also has a unit dedicated to consumer education and outreach, which participates in hundreds of events and reaches thousands of individual consumers annually. 

 

* This is a Special Appointment position that serves at the pleasure of the appointing authority.

GRADE

Insurance Investigator I, Appeals and Grievances - grade 14 (Starting Salary: $41,053 - $47,410/year)

Insurance Investigator II, Appeals and Grievances - grade 15 (Starting Salary: $43,669 - $52,353/year)

Insurance Investigator III, Appeals and Grievances - grade 16 (Starting Salary: $46,477- $56,865/year)

 

**Salary Guidelines apply to State employees**

POSITION DUTIES

The MIA’s Life and Health Division is recruiting for an Insurance Investigator, Appeals and Grievance at the I, II, or III level.  This position investigates consumer complaints regarding the denial of a claim or service based on medical necessity, and determines if the carrier is in violation of the Maryland Insurance Article.  The Insurance Investigator, Appeals and Grievance answers calls from citizens, attorneys, health providers and others regarding the complaint process; and responds to emergency calls concerning medical necessity denials.  At scheduled times, this position is required to be “on-call”, after-hours and weekends, to respond to consumer complaints received by telephone.

MINIMUM QUALIFICATIONS

Insurance Investigator I, Appeals and Grievances:

Education: Bachelor’s degree from an accredited college or university.

 

Experience: None

 

Note: Experience in the review of medical records or medical claims may be substituted on a year-for-year basis for the required education.

 

 

 

Insurance Investigator II, Appeals and Grievances:

Education: Bachelor’s degree from an accredited college or university.

 

Experience: Two years of enforcement/investigatory experience with a regulatory agency, licensed insurer, or accredited law enforcement agency.

 

Note:

1- Experience in the review of medical records or medical claims may be substituted on a year-for-year basis for the required education.

2- Possession of a J. D. degree may substitute for the minimum experience requirements.

 

Insurance Investigator III, Appeals and Grievances:

Education: Bachelor’s degree from an accredited college or university.

 

Experience: Three years of enforcement/investigatory experience with a regulatory agency, licensed insurer, or accredited law enforcement agency.

 

Note:

 

1- Experience in the review of medical records or medical claims may be substituted on a year-for-year basis for the required education.

2- One year of enforcement/investigatory experience with a regulatory agency, licensed insurer, or accredited law enforcement agency and possession of a J. D. degree may substitute for the minimum experience requirements.

BENEFITS

FURTHER INSTRUCTIONS

If you have any questions about this recruitment, please contact charrison@maryland.gov.

For immediate consideration, upload one WORD or PDF file, at the "Resume" tab, that contains:

1. a cover letter stating your interest and specific salary requirements; and

2. a current professional resume.

If you are unable to apply online, you may submit via mail.  Please be sure to include all documents listed above to ensure timely processing. Complete application packets may be mailed to:

Maryland Insurance Administration

Human Resources - Recruitment #:  19-009638-0004

St. Paul Place, Suite 2700

Baltimore, MD 21202

Incomplete submission will not receive consideration.

TTY  Users: call via Maryland Relay

We thank our Veterans for their service to our country, and encourage them to apply.

As an equal opportunity employer Maryland is committed to recruiting, retaining and promoting employees who are reflective of the State’s diversity.



Click on a link below to apply for this position:

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