Insurance Program Specialist

Position Summary:

The role is responsible for the administration analysis and oversight of the organizations insurance programs. The position ensures adequate coverage across all lines of insurance supports the renewal process coordinates claims activities and maintains compliance with regulatory requirements.

Key Responsibilities:
Manages day-to-day operations of insurance programs and processing of policy audit requests.

Assist with the insurance renewal process by gathering data preparing submissions reviewing proposals and negotiating policy terms with

brokers and carriers. Assembles and processes annual GL/PL exposure data actuary reporting.

Analyze insurance coverage exclusions and endorsements to ensure alignment with organizational risk exposure. Coordinates insurance

efforts between internal stakeholders brokers carriers and third-party administrators.

Track and monitor insurance claims coordinate with adjusters and legal counsel and maintain internal documentation. Full fills requests for

claims history COIs and new provider insurance coverage as appropriate or needed.

Maintain certificates of insurance policies and other documentation for internal use and third-party requests.

Manages assembles and processes insurance policy renewals for the organization. Manages fully insured claim processing.

Interfaces with insured to develop and submit property claims to insurance carriers.

Field and respond to inquiries from current and former team members with insurance related questions and requests for evidence of

current or past insurance and claims history.

Assist in identifying and assessing areas of risk and provide recommendations for mitigation and insurance solutions. Serves as direct

support for senior leadership with insurance related matters.

Prepare insurance-related reports dashboards and audits for leadership and compliance.

Ensure compliance with all applicable insurance regulations and reporting requirements.

Preferred Qualifications:

Insurance Principle experience coverages and industry practices

Emergency Preparedness experience

Insurance Policy experience

Project Management experience

Conflict of Interest experience

Claims History experience

Proficient in Microsoft Office Suite; experience with risk/claims management systems

Strong organizational skills and project management

Minimum Qualifications:
3 years of experience in Healthcare Risk Management Insurance Claims or Underwriting Human Resources or a Legal Field or a Bachelors Degree required.

Required Licensure/Certification:
Healthcare Risk Management (HRM) or Certified Professional in Risk Management Certification (CPHRM) within 24 months of hire.

EDUCATION:

LICENSES / CERTIFICATIONS:

PHYSICAL REQUIREMENTS:

For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations including continuing education requirements.

Any physical requirements reported by a prospective employee and/or employees physician or delegate will be considered for accommodations.

PAY RANGE:

The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience relevant qualifications specialty internal equity location and contracts.

Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race color creed religion sex (including pregnancy childbirth and related medical conditions) sexual orientation gender identity or expression national origin age disability predisposing genetic characteristics marital or familial status military or veteran status citizenship or immigration status or any other characteristic protected by federal state or local law.