State of Oklahoma · 6 hours ago
Claims Review Specialist II
Oklahoma County, OK
Full-time
Hybrid
Mid Level
$63K/yr - $63K/yrThe State of Oklahoma is seeking a Claims Review Specialist II to analyze and investigate consumer complaints and inquiries related to Property and Casualty, and Life and Health insurance. The role involves conducting interviews with claimants, providing technical knowledge regarding insurance questions, and maintaining effective communication throughout the inquiry process.
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Responsibilities
Conduct interviews with walk-in claimants to gather information and answer questions in an effort to assist claimant with filing a request for assistance. Explain process and procedures of consumer assistance division
Answer questions pertaining to the information submitted via feedback
Any other duties deemed necessary by the supervisor, including meetings, conferences, state of emergency issues, and outreach events and any necessary travel
Serve as intermediary for the inquirer and provide direct contact with the insurer
Plan, organize and implement a course of action for each consumer inquiry to provide the most efficient, prompt, and effective response within the jurisdiction of the department. Maintain effective communication with the consumer throughout the process
Convey response to the consumer or explain and facilitate the understanding of a response that may not be desirable
Provide technical knowledge, expertise, detailed information, and response to the public regarding various insurance questions and concerns
Responsible for answering phone calls from the public regarding insurance questions on policies, procedures, and statutes
Backup to the Claims Processor Reviewer
Perform other duties as required
Qualification
Required
Under limited supervision, analyze and investigate Property and Casualty, and Life and Health consumer complaints and inquiries received by the Consumer Assistance/Claims Division of the Oklahoma Insurance Department
Conduct interviews with walk-in claimants to gather information and answer questions in an effort to assist claimant with filing a request for assistance
Explain process and procedures of consumer assistance division
Answer questions pertaining to the information submitted via feedback
Any other duties deemed necessary by the supervisor, including meetings, conferences, state of emergency issues, and outreach events and any necessary travel
Serve as intermediary for the inquirer and provide direct contact with the insurer
Plan, organize and implement a course of action for each consumer inquiry to provide the most efficient, prompt, and effective response within the jurisdiction of the department
Maintain effective communication with the consumer throughout the process
Convey response to the consumer or explain and facilitate the understanding of a response that may not be desirable
Provide technical knowledge, expertise, detailed information, and response to the public regarding various insurance questions and concerns
Responsible for answering phone calls from the public regarding insurance questions on policies, procedures, and statutes
Backup to the Claims Processor Reviewer
Perform other duties as required
Be knowledgeable of both Property and Casualty and Life and Health insurance lines
Be knowledgeable of insurance laws, rules, and policies
Possess skill in time management and decision-making
Initiate, implement and complete required tasks to resolve all insurance questions, concerns, or complaints
Exercise judgment in reviewing claim files; handle confidential work with tact and discretion
Maintain effective working relationships
Communicate effectively
Level II- Bachelor's degree or equivalent education and experience
Experience in the insurance field with account management or customer assistance, demonstrating evidence of knowledge and skills to perform the tasks of the job
The selected applicant must pass a background check
Individuals may be required to pursue NAIC designations as job duties require
Upon hire, any applicant who is licensed as a producer/agent, adjuster or is otherwise affiliated with any entity that is regulated by the department must surrender their license and terminate any financial or non-financial affiliation with the entity that is regulated by the department
Preferred
Industry designation related to consumer assistance, CISR, considered a plus
Company
State of Oklahoma
State of Oklahoma is a government organization that provides community development, education, employment, and health services.
Founded in 1970
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Dan Cronin
CIO and Chief Transformation Officer
David Ostrowe
Chief Operational Officer
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