EMC Insurance Companies

Administration

• Analyzes and investigates claims to ensure compliance and timely payment of benefits
• Responds to agents and policyholders regarding pending claims and appeals
• Processes complex beneficiary and ownership changes and approves eligibility of waivers for life and disability income policies
• Collaborates with peers and management to ensure consistent interpretations of policies and claim payment methods
• Obtains reports, medical records, eligibility, and/or additional information required to investigate and process claims
• Prepares filings for all life reinsurance benefits and tracks status of payments
• Ensures that claims are in compliance with state and federal mandates and reviews for red flags associated with potentially fraudulent claims
• Trains new claims team members and assists current claims staff with processing issues
• Documents claims procedures and maintains the claims administration manual as assigned by the Claims Manager

Senior Claims Administrator

Consultant

• Leads end to end delivery of complex and/or enterprise-wide innovation initiatives
• Oversees the entire process from initial intake and scoping through to delivery and integration back into the core business
• Designs and facilitates innovation workshops and sessions, using design thinking and other creative methodologies to engage internal partners and stakeholders
• Provides high level consultative services to internal and external partners regarding innovative processes and ideas
• Collaborates with business units and external partners to identify challenges, gather requirements, and co-create innovative solutions
• Drives continuous improvement by capturing lessons learned, iterating on processes, and sharing best practices
• Supports the development of innovation capabilities across the organization via projects lead within other business units
• Defines and tracks success metrics—including learning milestones, early wins, ROI, and business unit satisfaction

Senior Business Innovation Consultant

Underwriter

• Prepares and approves renewals for accounts within authority limit with a focus on long term profitability, retention and achieving branch and company pricing goals
• Based on branch established guidelines, leverages negotiation skills to obtain adequate rate
• Reviews account information, including coverage details, claims history, and any relevant updates or changes
• Evaluates the risk profile of each account and assesses its eligibility for renewal based on established underwriting guidelines
• For accounts outside authority, prepares information for underwriter to complete the renewal
• Communicates with agents to ensure all renewal information has been requested and received
• Regularly collaborates with underwriters throughout the renewal process ensuring a holistic approach to managing the agency book of business
• Maintains proper file documentation
• Develops relationships with agents by providing excellent customer service to promote renewal retention
• Builds and nurtures relationships with agents by regularly engaging in meaningful interactions, such as face-to-face meetings, virtual meetings, phone conversations, and written communication
• Responds to concerns or issues raised by agents regarding endorsements and renewals promptly and effectively, collaborating with internal teams to find solutions that meet the needs of both the carrier and agency
• Reviews and approves endorsements that fall within a specified list of requirements and within authority
• Underwrites and provides endorsement quotes to agents
• Corresponds with agents for additional information
• Assesses the potential risks associated with proposed endorsements, taking into account factors such as policy coverage, loss history and claims data to evaluate the overall impact on the policy
• Determines if additional information or assessments are required for accurate decision-making
• Reviews and approves reinstatements and cancellations
• Assists agents with policy billing inquiries
• Performs support duties for branch departments including but not limited to, ordering and analyzing reports as appropriate, reviewing drivers, and completing monthly projects
• Collaborates with experienced underwriters and territory management team members to develop understanding of company and branch risk appetite, underwriting resources, and systems

Senior Claims Administrator

Senior Business Innovation Consultant

Underwriting Associate