Insurance Contract Examiner - Repost - Agency Promotional Only

Location: Gardiner,Maine,United States

Department of Professional and Financial Regulation - Bureau of Insurance/Consumer Health Care Division
Job Class Code: 0367
Grade: 22 (Professional/Technical)
Salary: $47,174.40 - $65,832.00/Annually
Location: Gardiner, ME 
Opening Date: November 15, 2024
Closing Date:  December 3, 2024

This is administrative work in examining life and health insurance contracts to determine compliance with Maine law. Work includes reviewing policy forms, riders, and endorsements used by insurance companies doing business within Maine; reviewing certificates issued pursuant to out-of-state group policies as well as processing complaints, inquiries, and requests for assistance from the public regarding insurance matters. Work is performed under limited supervision.  

Primary responsibilities include:  

• Reviews and analyzes life, accident, and health insurance contracts including policies, certificates, riders, and endorsements attached or included in order to determine compliance with Maine law.
• Consult with insurance company representatives in order to clarify, correct, and alter contract provisions where contracts conflict with Maine laws, rules, and regulations.
• Researches and evaluates insurance-related problems in order to develop solutions including improved procedures, changes in regulations, or proposed legislation.
• Advises Bureau of Insurance personnel in order to provide technical information regarding area of expertise.
• Responds to telephone queries and/or complaints from the public and conduct individual interviews in order to solicit or provide information and provide solutions to life and health insurance-related problems.
• Mediates settlements with life and health insurers in order to resolve complaints.
• Represent the agency and speak before various groups in order to provide information regarding life and health insurance.

Skills or knowledge required:

• Knowledge of life, health, and accident insurance.
• Knowledge of contract law as it relates to insurance.
• Knowledge of state insurance laws, rules, and regulations.
• Knowledge of practices and procedures of insurance and related industries.
• Knowledge of federal insurance programs.
• Knowledge of insurance examination and question development procedures.
• Ability to recognize conflicts in contracts (prohibited and required provisions).
• Ability to solve problems independently.
• Ability to communicate effectively.
• Ability to write clearly and effectively.
• Ability to read and understand insurance contracts.

Minimum qualifications:

Education, training, and/or experience demonstrating competence in any of the following: contract examination or administration, interpreting laws/rules, regulatory experience, and health care knowledge. Experience with insurance or insurance contracts preferred.

Contact information:

Questions about this position should be directed to Deputy Director, Kim E. Davis at Kim.E.Davis@Maine.gov.

Application Instructions:

Interested applicants need to apply online by selecting the "Apply for this opening" button along with uploading a cover letter, current resume, and copies of any transcripts or certifications you wish to have considered while evaluating your application.  In order for us to properly determine if you meet the minimum qualifications for any posting, you must be sure your resume includes month and year for any experience listed along with the duties and responsibilities associated with each particular time period.  Any experience that was not full-time employment should be identified as such. 

If you require a paper application, please download and print one here https://www.maine.gov/bhr/state-jobs/application-process or contact our office at 207-623-6700.  Paper applications for this posting should be submitted along with cover letter and resume before the closing date to Security & Employment Service Center, 45 Commerce Drive, Augusta, ME  04330 or faxed to 207-287-2018.  Be sure title of the job you are applying for is included.  Applications cannot be accepted after the posting closing date.  

Benefits of working for the State of Maine:

No matter where you work across Maine state government, you find employees who embody our state motto—"Dirigo" or "I lead"—as they provide essential services to Mainers every day. We believe in supporting our workforce's health and wellbeing with a valuable total