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Regulatory Data Reporting Technician I/II in Lansing, MI at AF Group

Date Posted: 9/5/2018

Job Snapshot

Job Description

PRIMARY RESPONSIBILITIES:

Technician I


• Serves as back up liaison for correspondence with regulatory agencies and agents, relating to regulatory data reporting.


• Runs reports on time cycles as required.


• Creates and/or edits submission files either manually or through the use of applications such as Excel and Access.


• Creates and files correction reports as necessary.


• Responsible for the timely submission of regulatory data filings.


• Categorizes and distributes departmental mail.


• Assist in investigating and resolving source system issues that cause errors on regulatory data submissions. Assist in investigating the cause of fines relative to regulatory reporting. Works with various internal department staff to correct claim and policy data as needed.


• Creates Rate Page documents for the Compliance Department; published on the company website, and for filing purposes.


• Responsible for all paper filing relative to regulatory data reporting.



Technician II




• Includes all responsibilities of Technician I.


• Trains and/or mentors Technician I.


• Primary liaison for production processes and/or issues related to regulatory data reporting.


• Primary company contact for internal inquiries related to regulatory data reporting.


• Develops and documents work flows as assigned.



PRIMARY RESPONSIBILITIES Continued:




• Responsible for the manual process of large deductible reporting.


• Designs and monitors data quality checks for data submissions.


• Assists in preparing test cases for system changes related to regulatory data reporting. Participates in the evaluation and approval of test data and implementation of system changes. Responsible for handling escalated cases from technician I.


• Works with IT contacts both in-house and contracted, if applicable, to ensure data reporting programs are working appropriately. Verifies programs are meeting regulatory requirements through development, testing and implementation stages. Recommends program modifications as needed.


• Responsible for testing newly developed applications in regard to regulatory data reporting.


• Performs duties related to all regulatory data reporting functions, including WCSTAT, WCPOLS, Financial Calls, Medical Call, DCI reporting, and state reporting.


• Keeps apprised of changing rules for data submission from regulatory agencies.


• Works with DCO representatives and agents to correct claims and/or policy data as needed. Works under minimum supervision.







EMPLOYMENT QUALIFICATIONS:

A. EDUCATION REQUIRED:
Technician I & II
High school diploma or G.E.D.

B. EXPERIENCE REQUIRED:
Technician I
Minimum two (2) years experience with an Insurance Organization.

Minimum two (1) year experience with an Insurance Organization.

Technician II
Minimum three (3) years in an insurance organization including experience with business systems support and systems development/testing.

C.

SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:


Technician I

• Knowledge in computers and company standard software programs, with intermediate knowledge in Excel, Word, and Access.


• Ability to create reports utilizing Excel programs.


• Ability to clearly and concisely communicate factual and technical information, written and orally.


• Ability to proofread documents for accuracy of spelling, grammar, punctuation and format.


• Ability to organize, prepare, analyze and interpret data to find and solve problems.


• Basic knowledge of the insurance business and other departments' functionality.


• Ability to correlate business processes with impacts to source systems and data used in bureau reporting.


• Ability to identify situations requiring intervention and take appropriate actions.


• Ability to document processes.


• Excellent oral and written communication skills.


• Ability to perform mathematical calculations and operate a ten-key adding machine.


• Ability to enter alpha/numeric data accurately.


• Ability to maintain confidentiality.


• Ability to work primarily independently.


• Ability to use independent judgment to remediate routine problems with submission files under general supervision of Bureau Reporting Supervisor or Technician II.

Technician II

• All skills of Technician I.


• Ability to comprehend the consequences of unusual situations and take appropriate actions and/or refer problems for necessary decision making.


• Thorough knowledge of the insurance business and other departments' functionality.


• Strong knowledge of insurance procedures and ability to analyze workers compensation data.


• Ability to establish work flows, manage multiple projects, and meet necessary deadlines.


• Knowledge of differences between states regarding regulatory data reporting.


• Ability to understand specifics of data submission files for all states.


• Strong understanding of business processes (policy processing and/or claims processing) and how they impact source system data.

• Ability to use independent judgment to remediate most problems with submission files.


• Ability to troubleshoot issues that arise with submission files and/or corrections to assist in determining whether a manual work around is appropriate, a system fix is necessary, whether there is a training issue, etc. Ability to funnel the findings to appropriate leadership to follow up and assist determining suitable action.


• Ability to use Business Objects and intermediate knowledge of EDW.


• Ability to create and use ad hoc reports as necessary to support troubleshooting and external requests.


• Ability to have increased contact with vendors regarding system issues and assist in resolution of issues.


• Understanding of regulatory data reporting workflows.


• Ability to troubleshoot or analyze moderately complex data or scenarios and determine corrective actions.



D. ADDITIONAL EDUCATION, EXPERIENCE, SKILLS, KNOWLEDGE AND/OR ABILITIES PREFERRED: These are in addition to the required qualifications - Do not state required qualifications.


Technician I

• An insurance designation or working towards insurance designation or accreditation preferred.


• Ability to troubleshoot or analyze moderately complex data or scenarios and determine corrective actions.



WORKING CONDITIONS:

Work is performed in an office setting with no unusual hazards. Travel required as necessary.

REQUIRED TESTING: Reading Comprehension, Alpha Numeric, 10-Key, Math, Intermediate Word, Intermediate Access Basic Access, Intermediate Excel, Intermediate Windows and Proofreading



Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled