This position requires the completion of Nationwide's LEADERSHIP MATTERS Certification. This required training for new leaders, will take place over the course of the first year in the role.
JOB SUMMARY: Supervises underwriting medical records units including screening and/or policy analysis. Uses veterinary clinical judgment in accepting, modifying, or rejecting risks based on a review of medical reports, claims activity, file information, and nature of medical condition. Responsible for quality underwriting, associate supervision and development, team building and training.
REPORTING RELATIONSHIPS: Reports to the NW Pet Manager; responsible for direct supervision of other support staff
CORE JOB DUTIES & RESPONSIBILITIES:
+ Supervises the execution of underwriting, screening and/or policy analysis in accordance with established guidelines and processes, state/regional objectives, and best practices. Typically has personal approval level for risks. Supervises the resolution of or handles complex underwriting issues.
+ Reviews and rates applications requiring additional evidence of insurability. Determines the need for and authorizes the ordering of clinical information, attending physicians' reports, claims reports, and other necessary information.
+ Analyzes requests for exceptions to underwriting policy and develop rationale to support the decision made. Consults with product and sales staff regarding issues related to risks, enrollment, and renewal of various policy risks.
+ Conducts policy review audits to ensure compliance with NW Pet underwriting policies and procedures. Confirms pre-existing conditions were not overlooked; requests additional information, as needed
+ Identifies gaps and makes recommendations for solutions.
+ Contributes to the on-going refinement and development of underwriting guidelines, policies and procedures and may communicate/train underwriting staff.
+ Promotes cooperative working relations in support of underwriting objectives with other functional areas (e.g., product, sales, customer service, Veterinary Services, etc.).
+ Maintains working knowledge of veterinary underwriting materials, manuals, rules, regulations, reference guides, procedures and practices pertaining to the underwriting of NW Pet Insurance.
+ Responsible for maintaining relationships with agents, members and other service center operations.
+ Responsible for complying with corporate and product initiatives.
+ Provides input to division budget. Is held accountable for performance against individual team budget. Monitors and reports data that may impact overall operation results.
+ Provides leadership to team members. Assigns resources to meet time lines, reviews work to ensure customer service and other needs are addressed, and recommends and implements changes to existing procedures.
+ Responsible for the supervision of associates including: performance management, training and development, workflow planning, hiring and placement, and disciplinary actions.
+ Performs other duties as assigned.
MINIMUM JOB REQUIREMENTS:
Education: Undergraduate degree in Business, Biology, Zoology or related Animal Science preferred.
License/Certification/Designation: CPCU or registered/Certified Animal Health Technician. Maintenance of state mandated Continuing Education Units preferred.
Experience: Typically six years experience in veterinary insurance underwriting or related insurance experience. Prefer experience working in a veterinary clinician role in a veterinary medical office or hospital.
Knowledge: Professional ability that requires a working knowledge of veterinary insurance underwriting practices, principles, and procedures. In-depth understanding of veterinary medical codes, terminologies, and definitions. Proven knowledge of NW Pet insurance risk selection and methods for modifying risks to make them acceptable. Maintains an understanding and adheres to insurance laws and regulations related to veterinary insurance underwriting procedures. Familiar with veterinary medical service organization insurance processes.
Skills/Competencies: Effective verbal and written communication skills to respond to inquiries or complaints from fellow NW Pet employees, policyholders, regulatory agencies or members of the veterinary community. Proven ability to understand and interpret medical records and supporting clinical documentation (i.e. written, oral, diagram, or schedule form, etc.). Demonstrated ability to read, analyze, and interpret veterinary medical, scientific and technical journals, financial reports and insurance policy contract language. Ability to deal with a variety of variables in situations where only limited information exists. Interpersonal skills to work collaboratively with cross-functional teams, supervising team (i.e. sales, customer service, Veterinary Services, etc.) and physicians, hospitals, regulatory agencies, etc. Ability to use personal computer and related medical management and business software. Ability to use analytical data to determine potential trends.
Values: Regularly and consistently demonstrates the Nationwide Values and Guiding Behaviors.
Staffing Exceptions to the above Minimum Job Requirements must be approved by the: hiring manager's leader and HRBP.
Overtime Eligibility: Not eligible (Exempt)
Working Conditions: Normal office environment. Extended work hours may be necessary to fulfill department service level agreements.
ADA: The above statements cover what are generally believed to be principal and essential functions of this job. Specific circumstances may allow or require some people assigned to the job to perform a somewhat different combination of duties.
Job Family/Function: UND/PET
Job Evaluation Activity: 02/2017 BS
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