Insurance Operations Technical Specialist (FT)

In the role of Ins. Ops Tech Specialist, you will use your knowledge of insurance processes and procedures to help improve the efficiencies and quality of services performed by SFM's Ins. Ops department. You will help develop other team members and act as an mentor. This job requires knowledge working within a Property and Casualty Insurance environment and the ability to work with a variety of people along with strong trouble shooting capabilities. SFM believes that our exceptional and motivated employees are our greatest strength, and we are committed to creating the best work environment.

This is a hybrid role, so some in office work is needed. Applicants must live in MN.

The Role : Provides technical leadership to the Insurance Operations and Medical Cost Containment (IOMCC) Team. Actively works on improving the efficiency and quality of services performed by the IOMCC team. Works with various internal customers on service issues and provides timely solutions. Participates on multi-functional corporate projects as a technical expert in SFM corporate operations. Manages vendors that work with IOMCC. Collaborates with IOMCC Director to develop best practices and ensure quality service delivery. Mentors team members to assist with professional development and monitors team skill levels for effective delegation.

Our benefits include:

• Affordable Medical, Dental, Vision Insurance, HSA, FSA
• Flexible hybrid work environment
• Traditional and Roth 401(k) plans with company match
• Company contributions to help pay off student loans
• Monthly home internet allowance
• Free life insurance, STD & LTD
• Opportunities for annual gainshare bonus
• Pet insurance
• Generous PTO
• 9 paid holidays
• Paid parental leave
• Annual company-wide volunteer day
• Discounts on gym memberships, fitness apps and weight loss programs
• Adoption financial assistance

Responsibilities

Insurance Operations and Medical Cost Containment

1. Partners with Information Services, Strategic Business Unit Leaders and Insurance Operations and Medical Cost Containment Director to constantly evaluate corporate services processes for cost efficiencies and quality/service improvements.
2. Develops and maintains protocols for an internal audit process that defines success measurements for Insurance Operations and Medical Cost Containment team to address productivity and accuracy. Communicates audit results regularly to Insurance Operations and Medical Cost Containment Director.
3. Leads the troubleshooting of service issues for the Insurance Operations and Medical Cost Containment team. Works with the Insurance Operations and Medical Cost Containment Director to identify areas where additional training or process changes are required to solve repeated issues. Provides exceptional and timely service for issues to SFM team members.
4. Leads first level support for CompOnline/SAM in association with the CX/UX team by providing training/mentoring to the Insurance Operations and Medical Cost Containment team and working closely with key business leaders in Underwriting Tech, Claims Tech, and Information Services.
5. Participates as the Insurance Operations and Medical Cost Containment representative for multi-functional projects within SFM. Communicates status of project work to team members and involves others as appropriate.
6. In coordination with Human Resources and Insurance Operations and Medical Cost Containment Director determines the need for and delivery of technical training and partners with them to enhance training materials and programs to increase the technical knowledge and staff expertise.
7. Stays current on new tools and techniques to improve our operations including mailing, scanning, data entry, payment, and electronic document processing. Researches and proposes new initiatives to decrease costs, improve throughput/efficiency, or improve ease of doing business.
8. Works closely with the Medical Support Reps to track and address medical provider issues. Proactively seeks out ways to improve relationships with providers and to reduce SFM overhead costs in dealing with issues.
9. Assists with the management of medical cost containment vendors and acquisition of Durable Medical Equipment by mentoring staff and creating effective processes.
10. Assists in evaluating and completing tasks that have been sent through the review process as needed.
11. Manages all equipment used within the department, including vendor relationships for equipment acquisition and repair.
12. Manages a variety of vendor relationships for services and supplies.
13. Monitors and modifies auto-attendant phone system for most effective call routing and customer service.
14. Mentors team members to assist in their professional development. This includes delegation of work to team members and identification when delegation is not effective, or skills levels do not meet work challenges. Communicates to the Insurance Operations and Medical Cost Containment Director issues with team member work quality and/or productivity.

Operations Focus

1. Identifies and implements policies, practices and procedures and communicates these best practices to the team.
2. Ensures operational compliance with best practices and quality assurance standards.
3. Seeks out new processes, and identifies and makes recommendations to improve efficiencies through the use of technology, or the improvement of current work processes.
4. Responds to escalated phone calls and issues generated by team members within the department related to general and or complex service requests (calls/emails).

What We'll Love About You

• Bachelor's degree or four years' experience in related field.
• Five plus years experience working in an insurance support environment preferably workers' compensation and/or casualty insurance.
• Effective mentoring skills and desire to help others learn.
• Technical knowledge and application of imaging and mail service functions.
• Must have the ability to be focused on continuous quality improvement with skills to facilitate change.
• Serves as a positive role model to team members.
• Ability to apply confidentiality when appropriate.
• Exceptional communication skills in order to interact in a team environment and to collaborate with other business units.
• Strong organizational and troubleshooting skills including the ability to manage multiple projects and work with minimal direction.
• Excellent customer service abilities and able to manage difficult situations effectively.
• Ability to assimilate, understand and analyze information
• Ability to delegate to ensure successful completion of projects and/or assignments.
• Excellent abilities to work in a fast-paced environment with minimal direction.
• Highly developed computer skills, including demonstrated proficiency with Word, Excel, PowerPoint and Outlook.
• Must be a strategic thinker with the ability to see the big picture.

Physical Requirements

Work takes place in a semi paperless environment within an office setting or home office setting, using standard office equipment such as computers, phones, photocopies, which requires being stationary for extended periods of time. While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand; walk; use hands and fingers, handle or feel; and reach with hands and arms and work with close vision. This position requires the ability to occasionally lift office products and supplies, up to 20 pounds. Work is performed indoors with little to no exposure to extreme outdoor weather conditions.

__________________________________________________________

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

SFM is unique in that we are small enough that your voice is heard but has all the benefits and perks of a larger employer. We value your opinion, help you reach your goals, and make it easy for you to maintain work-life balance. SFM is committed to creating the best work environment and believes that our exceptional and motivated employees are our greatest strength. SFM emphasizes work life balance, and our benefit package is designed to assist you navigate your work-life journey.

About SFM

Since 1983, our mission has been to be the workers' compensation partner of choice for agents, employers and their workers. In that time, we've expanded to a little over 20,000 customers in the Midwest and grown our offerings to include vocational rehabilitation, safe patient handling, loss prevention, medical services and more. Though much has changed through the years, our focus continues to be unrivaled customer service, safety, and providing better outcomes for employers and injured workers.

SFM Mutual Insurance Company and each of its parent companies, subsidiaries and/or affiliated companies are Equal Opportunity/Affirmative Action Employers. All employment decisions are made without regard to race, color, religion, sex, national origin, age, sexual orientation, marital, familial, or veteran status, medical condition or disability, or any other legally protected classification.

SFM Companies, EEO/AA Employers. SFM is a participant of E-Verify