WC Product and Statistical Specialist

4 days ago

Blue Bell, United States PMA Companies Full time
The Workers Compensation Product Specialist is responsible for providing three forms of support for the Workers' Compensation line of business, including enhancing operational excellence, contributing technical expertise, and maintaining regulatory compliance.

  • In coordination with the Regulatory Unit, ensure the timely approval or adoption of Workers' Compensation filings.
  • In coordination with Underwriting Operations and Insurity, ensure that new or amended rates, rules and forms are supported in policy writing systems in an accurate and timely fashion.
  • Communicate changes to Underwriting Segments and Underwriting Operations in advance of effective dates.
  • Ensure the Customer Service Center has access to, and updated supplies, of current and compliant WC posting notices.
  • Develop and maintain reference materials related to Operational Excellence, Technical Expertise and Regulatory Compliance.
  • Management of relationships with NCCI, WCIRB, and other state and rating bureaus.
  • Monitor the availability of rates, rules, and forms by underwriting company and jurisdiction, identify gaps, and recommend solutions.
  • Develop and obtain approval for proprietary filings that meet the business objectives of the underwriting segments, including group and program business. Assist with the periodic review of Loss Cost Multipliers.Assist Operations with testing, problem solving, and coverage/rule interpretation.
  • Respond to internal inquiries regarding filed rates, rules, forms, and policy writing systems.
  • Retain all correspondence between the Segments, CAT Committee, CUO and CEO
  • Maintain an inventory of all referrals, including a concise summary of the account, Committee decisions, significant considerations expressed by the Committee, and the primary reason for any declinations
  • Track Segment adherence to CAT guidelines and communicate noncompliance as needed
  • Provide Segments with a quarterly assessment of compliance with CAT guidelines and a rolling list of renewals that must be referred in the next 12 months
  • Prepare the presentation materials for the quarterly meeting of the Executive Team
  • Identify significant or unexpected variances in typical results, determine the cause of those variances and summarize findings
  • Review the presentation materials and findings with the VP Product Management
  • Approval of applications for Drug Free and Safety credits, and Underwriting Rules associated with the policy issuance system.
  • Interaction with the various state agencies for workers' compensation matters. The interaction includes, but is not limited to, termination reporting, bureau criticisms, policy reporting, and proof of coverage matters.
  • Analysis of NCCI and Independent Bureau circulars, notices from State Departments of Insurance, and jurisdictional surcharges and assessments.
  • Review and evaluate WCPOLS reporting and state errors, and management of the Access database used to track this activity.
  • Work with the branch offices, operations, and information systems teams as appropriate to identify and resolve any policy errors/rejects in policy reporting and criticisms that are identified.
  • Ensure compliance with, and maintain documentation of, all jurisdictional requirements related to policy reporting, posting notices, and cancellation and non-renewal requirements.
  • Respond to Segment inquiries related to jurisdictional compliance.
  • Support responses to inquiries or criticisms from Rating Bureaus and Departments of Insurance.
  • Coordinate activities among Claim, Information Systems, Product Management, and the Customer Service Center (CSC) to ensure PMA compliance with Unit Statistical Reporting requirements
  • Ensure that there are clearly defined responsibilities for each department involved in the Unit Statistical Reporting process
  • Ensure that the WCSTAT (Workers Compensation Statistical Reporting Specifications) is understood and monitored by both Product and Claim, and that the appropriate department(s) amends PMA processes and systems as required
  • Act as PMA's authority on regulatory requirements regarding correction reports
  • Publish and maintain guidelines for CSC to follow when responding to agent or branch inquiries regarding correction reports, supplemented by training and CIC Matters as needed
  • Demonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.

Required experience:

  • Bachelor's degree or 10 years of Workers' Compensation experience.
  • Thorough understanding of Workers' Compensation coverage forms, rules, and rating plans.
  • Thorough understanding of policy processing requirements, including policy forms, premium, taxes and surcharges, and policy reporting.
  • Strong organizational skills with the ability to manage multiple priorities.
  • Strong research and analytical skills, with the ability to translate findings into decisions and recommendations.
  • Demonstrated ability to collaborate effectively with others, internally and externally.
  • Strong written and verbal communication skills.
  • Proficient in Microsoft Office suite, and management and development of Access database and Sharepoint sites.

Beneficial experience:

  • Knowledge and experience with the Insurity Policy Decisions policy processing system.
  • Developing and testing specifications for policy processing systems, independently or in conjunction with others.
  • Reviewing Circulars published by NCCI, independent rating bureaus, or Departments of Insurance.
  • Developing rate and rule filings.
  • Developing policyholder notices.
  • Supporting group or program business.

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