Insurance Program Specialist
Rochester Regional Health, Rochester, NY, United States
Insurance Program Administrator
The role is responsible for the administration, analysis, and oversight of the organization's insurance programs. The position ensures adequate coverage across all lines of insurance, supports the renewal process, coordinates claims activities, and maintains compliance with regulatory requirements.
Key Responsibilities:
Manages day-to-day operations of insurance programs and processing of policy audit requests.
Assist with the insurance renewal process by gathering data, preparing submissions, reviewing proposals, and negotiating policy terms with brokers and carriers. Assembles and processes annual GL/PL exposure data actuary reporting.
Analyze insurance coverage, exclusions, and endorsements to ensure alignment with organizational risk exposure. Coordinates insurance efforts between internal stakeholders, brokers, carriers, and third-party administrators.
Track and monitor insurance claims, coordinate with adjusters and legal counsel, and maintain internal documentation. Full fills requests for claims history, COIs, and new provider insurance coverage as appropriate or needed.
Maintain certificates of insurance, policies, and other documentation for internal use and third-party requests.
Manages, assembles and processes insurance policy renewals for the organization. Manages fully insured claim processing.
Interfaces with insured to develop and submit property claims to insurance carriers.
Field and respond to inquiries from current and former team members with insurance related questions and requests for evidence of current or past insurance and claims history.
Assist in identifying and assessing areas of risk and provide recommendations for mitigation and insurance solutions. Serves as direct support for senior leadership with insurance related matters.
Prepare insurance-related reports, dashboards, and audits for leadership and compliance.
Ensure compliance with all applicable insurance regulations and reporting requirements.
Preferred Qualifications:
Insurance Principle experience, coverages and industry practices
Emergency Preparedness experience
Insurance Policy experience
Project Management experience
Conflict of Interest experience
Claims History experience
Proficient in Microsoft Office Suite; experience with risk/claims management systems
Strong organizational skills and project management
Minimum Qualifications:
3 years of experience in Healthcare, Risk Management, Insurance Claims or Underwriting, Human Resources or a Legal Field or a Bachelor's Degree required.
Required Licensure/Certification:
Healthcare Risk Management (HRM) or Certified Professional in Risk Management Certification (CPHRM) within 24 months of hire.
PAY RANGE:
$70,000.00 - $95,000.00
CITY:
Rochester
POSTAL CODE:
14621
The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.
Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.
The role is responsible for the administration, analysis, and oversight of the organization's insurance programs. The position ensures adequate coverage across all lines of insurance, supports the renewal process, coordinates claims activities, and maintains compliance with regulatory requirements.
Key Responsibilities:
Manages day-to-day operations of insurance programs and processing of policy audit requests.
Assist with the insurance renewal process by gathering data, preparing submissions, reviewing proposals, and negotiating policy terms with brokers and carriers. Assembles and processes annual GL/PL exposure data actuary reporting.
Analyze insurance coverage, exclusions, and endorsements to ensure alignment with organizational risk exposure. Coordinates insurance efforts between internal stakeholders, brokers, carriers, and third-party administrators.
Track and monitor insurance claims, coordinate with adjusters and legal counsel, and maintain internal documentation. Full fills requests for claims history, COIs, and new provider insurance coverage as appropriate or needed.
Maintain certificates of insurance, policies, and other documentation for internal use and third-party requests.
Manages, assembles and processes insurance policy renewals for the organization. Manages fully insured claim processing.
Interfaces with insured to develop and submit property claims to insurance carriers.
Field and respond to inquiries from current and former team members with insurance related questions and requests for evidence of current or past insurance and claims history.
Assist in identifying and assessing areas of risk and provide recommendations for mitigation and insurance solutions. Serves as direct support for senior leadership with insurance related matters.
Prepare insurance-related reports, dashboards, and audits for leadership and compliance.
Ensure compliance with all applicable insurance regulations and reporting requirements.
Preferred Qualifications:
Insurance Principle experience, coverages and industry practices
Emergency Preparedness experience
Insurance Policy experience
Project Management experience
Conflict of Interest experience
Claims History experience
Proficient in Microsoft Office Suite; experience with risk/claims management systems
Strong organizational skills and project management
Minimum Qualifications:
3 years of experience in Healthcare, Risk Management, Insurance Claims or Underwriting, Human Resources or a Legal Field or a Bachelor's Degree required.
Required Licensure/Certification:
Healthcare Risk Management (HRM) or Certified Professional in Risk Management Certification (CPHRM) within 24 months of hire.
PAY RANGE:
$70,000.00 - $95,000.00
CITY:
Rochester
POSTAL CODE:
14621
The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.
Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.