Workers’ Compensation Technical Specialist
The Workers’ Compensation Technical Specialist establishes, implements and assesses the effectiveness of best practices. This position will coach, train and mentor internal and external stakeholders on guidelines, standards and other technical matters. This individual will analyze quantitative and qualitative business indicators and make technical decisions and recommendations in accordance with delegated authority.
Education and Experience:
• A Bachelor’s degree from an accredited college or university is required. Commensurate experience may be considered. • A minimum of seven years full-time or equivalent part-time paid underwriting experience with an insurance carrier strongly preferred. A minimum of three of the seven years’ underwriting or management experience must be with a workers’ compensation or property and casualty insurance carrier or equivalent workers’ compensation program. • Experience with project management preferred. • Professional insurance designations relevant to area of expertise desired.
1. Provide technical subject matter expertise to strategic business teams and other disciplines to support business plan objectives. This includes but is not limited to policies, strategy and tactics, product development, business services, filings, processes and workflows (including automation and business rules), regulatory compliance and market conduct matters. 2. Perform regular quality control and participate in quality audits. 3. Collaborate as needed with senior management on larger, more complex accounts requiring special expertise. 4. Manage development projects – including business requirements and timelines – that impact coverage, pricing, rating, systems logic, automation, and best practices. 5. Assist in the development of pricing strategies from the individual risk to portfolio levels using models and methodologies to support a profitable and competitive pricing approach to the market. 6. Develop and implement strategic and tactical product and service development initiatives using trend monitoring, feedback from stakeholders and marketplace competitor review. 7. Present to and train internal and external stakeholders on products and services and their associated processes, based on a solid understanding of and impact to field constituents such as agents, underwriting, customer service, marketing and policyholders. Develop appropriate supporting materials. 8. Gather and analyze competitor product, service and pricing intelligence (external) and product and service trends/results (internal) and recommend new and revised products, processes and systems. 9. Create innovative solutions as a result of competitor and internal trend analysis and work with other disciplines to gather input regarding product and service changes and ideas. 10. Develop internal guidelines, policies and procedures that address business needs and support business objectives. Determine internal systems impact due to process changes. 11. Investigate compliance and regulatory issues and recommend appropriate business solutions. 12. Assist in the development, use and maintenance of Guaranteed Cost and Loss Sensitive WC Policy Underwriting tools and Loss Frequency and Severity Benchmarks. 13. Create and maintain other necessary underwriting instructions and policy. 14. Non-essential function: other duties as assigned.
• Knowledge of policy and procedures regarding underwriting administration, risk administration and classification, insurance and risk management, accounting or business administration, premium audit or underwriting and loss control. • Ability to apply technical expertise and sound logic to identify and analyze problems and implement effective underwriting solutions. • Demonstrate a solid understanding of compliance issues and regulatory environment in project development and implementation. • Ability to use relevant information and individual judgment to determine compliance with regulations or standards. • Ability to collaborate effectively with internal and external stakeholders. Ability to build and maintain positive working relationships with policyholders and their leadership. • Superior understanding of the form and content of insurance policies. • Knowledge of cost rating plans and related pricing methods and procedures, and ability to use this information to determine and calculate business exposures, classifications, experience or other rating plan modifications. Understand credit risks in order to determine the appropriate guaranteed cost coverage for each business. • Ability to analyze and evaluate specific complaints and inquiries regarding insurance contracts, coverage, and rating plans. • Ability to read and interpret financial statements. • Exceptional oral communication skills. • Excellent analytical, research, documentation and writing skills. • Effective organizational skills, including the ability to effectively manage multiple projects. • Demonstrate sound judgment and work independently or with minimal direction. • Knowledge of design, implementation and interfaces of current systems and applications. • Ability to apply confidentiality when appropriate. • Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. • Proficient in Excel.