Department of Insurance, Financial Institutions & Professional Registration
  • 14-Jul-2017 to 14-Sep-2017 (CST)
  • Jefferson City, MO, USA
  • $35,640-$36,924
  • Salary
  • Full Time

Missouri State Employees' Retirement System (Defined benefit plan), Major Health Insurance, Dental, Vision (provided for employees and available for families), Paid Life Insurance (amount equivalent to annual salary), Long-Term Disability Insurance, Cafeteria Plan, Deferred Compensation Plan, 12 paid holidays per year, 10 hours of annual leave per month, 10 hours of sick leave per month, Credit Union,


JOB OPPORTUNITY NOTICE

 

Insurance Consumer Complaint Specialist I (Life and Health)

STARTING ANNUAL SALARY: $35,640 - $36,924 (commensurate with education and experience)

Full-time, benefited position

The Missouri Department of Insurance, Financial Institutions and Professional Registration, Division of Consumer Affairs, has a full-time position located in Jefferson City, Missouri.

This position is responsible for responding to inquiries and complaints from the general public and reviewing claim and benefit handling to ensure life and disability plan compliance with federal and state laws and regulations. An employee in this position will have a specialization or concentration in life/disability insurance. An employee in this position is assigned to the Life and Health Unit of the Consumer Services Section and is responsible for reviewing consumer complaints as to life insurance coverage and corresponding with company officials to communicate areas of non-compliance or deficiencies in coverage or claims handling. Employees refer more complex questions to higher level staff. The employee will advocate on behalf of the consumer as to issues of coverage or claims denial. Until the more technical phases of the work are learned, the employee works under close supervision; thereafter, the employee is required to exercise judgment in the performance of assigned responsibilities. General supervision is received from the Life and Health Unit Manager.

 

EXAMPLES OF WORK PERFORMED:

Investigates and responds to consumer inquiries and complaints regarding insurance claims procedures, policy provisions, claim denials, and premium billing practices. Enters complaint information into computer system. Complaints and inquiries include all communications with consumers in person, via telephone, electronic mail or fax, or in writing. Reviews and analyzes data to determine validity of complaints and to ensure insurance company compliance with contract requirements, state insurance laws, rules and regulations; refers cases of non-compliance for review by management with recommendations for action. Requests documentation, information and assistance from insurance companies; serves as liaison and attempts to resolve disputes between complainants and insurance companies. Refers complaints involving suspected insurance agent fraud to appropriate investigative staff; assists in gathering evidence of unacceptable agent practices, as necessary. Refers complaints involving violations of federal law(s) to the appropriate federal agency; tracks the resolution of such referrals. Maintains records of the investigation and resolution of consumer complaints and inquiries. Performs other related work as assigned.

 

EXAMPLES OF REQUIRED KNOWLEDGES, SKILLS, AND ABILITIES:

Working knowledge of insurance industry and life/disability plan practices, claims processing and complaint procedures. Working knowledge of state laws, rules and regulations, and court decisions affecting life/disability insurance or life/disability coverage. Specific knowledge of life/disability insurance, life/disability coverage and the types of life/disability plans, policies and products offered to Missouri consumers. General knowledge of insurance terminology and insurance company practices. Ability to explain insurance company policies and practices. Ability to review claims documentation and research complex life/disability issues. Ability to communicate effectively and to prepare clear and concise reports. Ability to analyze facts and present logical solutions to problems. Ability to establish and maintain effective working relationships with other employees, consumers, insurance company representatives, state and federal officials. Ability to communicate with consumers in a courteous, polite and professional manner and accurately answer questions about state and federal laws as they pertain to life/disability coverage and claim issues. Ability to operate a computer and utilize a variety of computer software.

 

EXPERIENCE AND TRAINING QUALIFICATIONS:

Graduation from an accredited four-year college or university with specialization in insurance, risk management, business or public administration, social sciences or closely related areas OR four years of professional or technical experience in insurance, investigations or public relations, of which two years must have been in one or more of the areas listed below; and possession of a high school diploma or a GED certificate.

 

AREAS OF QUALIFYING EXPERIENCE

  1. Experience in life/disability insurance underwriting, contract development, agency management, sales, or in processing life/disability claims in an insurance company or closely related life/disability insurance experience.
  2. Experience in insurance complaint investigations, civil or criminal investigations, or comparable investigatory experience.
  3. Experience in processing consumer complaints in a public or private setting.
  4. Experience in an insurance regulatory agency which involved interpretation, application and/or enforcement of statutes and regulations.

 

 

Application Process: If interested, please apply online at http://difp.mo.gov/jobs and view current job opportunities. Once on the webpage, complete the "Apply Now" information to the right, then click "Apply for this Position". This will direct you to the online application. You should also submit a current resume and any college transcripts by attaching the documents to the application.

 

Screening to begin immediately upon receipt of applications.

 

AN EQUAL OPPORTUNITY EMPLOYER

 

Department of Insurance, Financial Institutions & Professional Registration
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