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HEALTH INSURANCE CONSUMER ADVOCATE
Salary: $24.78-$27.53 Hourly
Job Type: Full time
Location: Cheyenne, WY - In-office
GENERAL DESCRIPTION:
Acts primarily as a consumer advocate in resolving problems and consumer complaints with life and health insurance companies doing business in Wyoming in the lines of health insurance, life insurance, and annuities. Assists in the regulation of insurance in protecting the Wyoming consumer from unfair trade practices and improper claim settlements.
ESSENTIAL FUNCTIONS:
The listed functions are illustrative only, and are not intended to describe every function that may be performed in this position.
Provides technical advice and assistance to Wyoming consumers regarding state insurance statutes and regulations and acts as a liaison for complaints with federal agencies.
Represents the agency fairly and impartially in the advice to consumers, agents, and insurance companies in the resolution of complaints involving disputes such as billing discrepancies, non-renewals, cancellations, and claims settlements, etc.
Confers with clients, advises them regarding their complaints, and facilitates the settlement of claims and insurance issues between the consumer, agents, and insurance companies.
Receives and investigates complaints made by individuals to the agency.
Resolves consumer complaints through verbal and detailed written communications.
Makes recommendations, negotiates, and attempts to resolve disputes before being referred to an administrative hearing.
Interprets complex insurance contracts, stays current with insurance issues and case studies involving opinions with regard to health insurance, life insurance, and annuities
Opens and maintains consumer complaint files.
Refers identified conduct of unfair and deceptive trade practices and claims settlement violations for administrative action.
Coordinates investigations due to allegations of fraud.
Acts as a consultant with clients, interdepartmental units, and outside sources.
Implements agency policies and procedures for coordinating referrals and conducting investigations.
Completes report requirements on cases or individuals; may provide continuing education classes to individuals.
Responsible for the initiation, investigation, and closure of inquiry and complaint files from insurance consumers regarding producers, brokers, and third-party administrators.
Assists with market conduct examination of insurance companies and coordinates with other state regulatory agencies.
MINIMUM QUALIFICATIONS:
Education:
Bachelor's Degree (typically in Business)
Experience:
0-1 year of progressive work experience (typically in Business)
OR
Education & Experience Substitution:
3-4 years of progressive work experience (typically in Business)
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