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Senior Claims Processor/Reviewer

Recruitment #190513-UNCE-241

Introduction

APPLICATION INSTRUCTIONS:

Submit resumes to:
angie.powers@oid.ok.gov

This position is opened until filled.
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#19-06

The Oklahoma Insurance Department has an opening in the Consumer Assistance Division for a Senior Claims Processor/Reviewer. The vacant position is a level III, with a salary of $42,500.This position is open until filled.

DEFINITION:
Under limited supervision, analyze and investigate consumer complaints and inquiries received by the Consumer Assistance/Claims Division of the Oklahoma Insurance Department.

DUTIES AND RESPONSIBILITIES:
• Process External Review requests (denials of final appeals from insurance companies)
• Review completed files from three (3) L&H Analysts for quality control
• Answer telephone calls from consumers in Oklahoma
• Contacts insurance companies to aid in closure of files
• Meet  with walk-in  claimants as needed
• Respond and distribute website feedbacks
• Meets with L&H Analysts to discuss hard/complicated files
• Exclusively work files sent by the Oklahoma Attorney General (L&H)
• Attend meetings as needed regarding problematic insurance companies
• Assist Prometric,  the state licensing vendor, once a year with test writing
•  Serves as back up to the Director of CA in their absence
• Trains new hires
• Responsible for Performance Evaluations for Life & Health Analysts
• Any duties as assigned by the Director

KNOWLEDGE, SKILLS AND ABILITIES:
• Be knowledgeable of insurance laws, rules and policies
• Possesses skill in time management and decision making
• Initiate, implement and complete required tasks to resolve all insurance questions, concerns or complaints.
• Exercise judgment in reviewing claim files; handle confidential work with tact and discretion
• Maintain effective working relationships
• Communicate effectively, both orally and in writing.

EDUCATION AND EXPERIENCE:
Bachelor’s Degree and seven years’ experience in the insurance field or an equivalent combination of education and experience including at least of the following certifications/designations: CISR, or ACS.

NOTE:
Upon hire, any applicant who is licensed as a producer/agent, adjuster or is otherwise affiliated with any entity that is regulated by the department must surrender their license and terminate any financial or non-financial affiliation with the entity that is regulated by the department. The selected applicant must pass a background check. Individual may be required to pursue NAIC designations as job duties require.

Employees of the Oklahoma Insurance Department are unclassified employees of the state.  For benefits offered by the State of Oklahoma to employees of the state, please use this link to access the Office of Human Capital Management benefits page at https://omes.ok.gov/services/employee-benefits

EEO/AA

Conclusion

Veteran's Preference Points Apply only for initial appointment in the Classified Service.



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