Regulatory Filing and Insurance Risk Specialist

REPORTS TO: Regulatory Filing and Insurance Risk Supervisor

LOCATION: Allegiance office, hybrid

FLSA STATUS: Non-Exempt

POSITION RESPONSIBILITIES:

Through a respectful, constructive and energetic style guided by the objectives of Allegiance Benefit Plan Management, Inc. (Company), the Regulatory Filing and Insurance Risk Specialist assists with maintaining Company licensing and insurance, responding to subpoena record requests, printing and enveloping outgoing subrogation mailings, scanning certain incoming mail and helps coordinate corrections for Form 1099-MISC filings as well as the receipt of all Form W-9s and assist with posting SPDs and plan amendments.

ESSENTIAL JOB FUNCTIONS:

Essential job functions include the following. Other functions may be assigned as business conditions change.

• Assists with managing all regulatory licensing for all Allegiance companies and assist with tracking documents and communications with Cigna corporate offices and other Allegiance departments (TPA licenses, individual producer licenses, IUI licenses, ACM licenses) and City of Missoula licenses - tracking applicable deadlines, renewals, etc.
• Assist with providing copies of licenses to eligible recipients when requested.
• Assist with the completion of annual reports required in all states that Allegiance is registered with the Secretary of State and any additional reports required for ABPM, ACSI, ACM and IUI.
• Assist with the renewal of the E&O, Crime and Cyber insurance policies including gathering necessary information required for the applications and helps provide copies of declaration of coverage sheets when requested.
• Assists with the tracking of all Form 1099-MISCs that are returned as undeliverable and assist with sending corrected information to vendors.
• Assist with maintaining file of all Form W-9s received and with updating provider files with Form W-9 information when necessary.
• Assist with risk insurance placement and renewal tracking and interaction with insurance brokers.
• Assists with the submittal of Network Adequacy filings via SERFF (as well as any other SERFF filings that may be required in the future) to State of Montana.
• Assist with the posting and maintaining of all Plan Documents, signed amendments and related group notes (including Pharmacy Import Decision flowcharts and ID card templates, etc.) on MAIN and LIN in the current system and the equivalent in any future system as well as adding notations where necessary.
• Assist with the managing of subpoenas for records including pre-payment estimates, verification of HIPAA authorizations, prints records when all payments/authorizations are received and sending records out.
• Prints and envelops outgoing subrogation mailings.
• Scanning of certain incoming mail.
• Contributes to the daily workflow with regular and punctual attendance.
• Other duties as assigned.

SUPERVISION EXERCISED:

• None

PHYSICAL WORKING CONDITIONS:

Physical requirements are representative of those that must be met to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Sitting 50%

Reaching Medium

Standing 25%

Manual Dexterity High

Walking 25%

Telephone Yes

Kneeling Medium

Computer Screen High (visual acuity corrected to 20/30)

Bending Medium

Lifting up to 20 lbs.

JOB SPECIFICATIONS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Minimum Education: High school graduation or GED required plus two years of college or graduation from a technical school. Bachelor's degree preferred.

Certification(s) Required: None.

Minimum Experience: Computer experience required. Previous administrative experience preferred.

Other Qualifications:

Excellent oral and written communication skills required.

PC skills, including Corel Word Perfect, Windows, Word, Outlook, Excel, Access and PowerPoint.

Must be able to adapt to software changes and trouble shoot minor issues.

Excellent listening skills.

Ability to show initiative.

High level of interpersonal skills to work effectively with others.

Ability to project a professional image and positive attitude in any work environment.

Ability to comply with privacy and confidentiality standards.

Ability to be flexible, work under pressure and meet deadlines.

Ability to solve problems with professionalism and patience.

Ability to operate typical office equipment.

Working knowledge of general office procedures.

Familiarity with health plan benefits/insurance/medical language

Excellent detail skills, must be thorough and have good proofreading skills

Ability to read, understand and summarize amendments briefly and concisely.

Working knowledge of Adobe Acrobat (not just Adobe Reader)

Ability to prioritize, accomplish tasks in timely manner

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel as classified.

*Allegiance Benefit Plan Management, INC is an Equal Opportunity Employer. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: recruiting@askallegiance.com for support.