Regulatory Filing and Insurance Risk Specialist

REPORTS TO: Regulatory Filing and Insurance Risk Supervisor

LOCATION: Allegiance office, hybrid

FLSA STATUS: Non-Exempt

POSITION RESPONSIBILITIES:

Through a respectful, constructive and energetic style guided by the objectives of Allegiance Benefit Plan Management, Inc. (Company), the Regulatory Filing and Insurance Risk Specialist assists with maintaining Company licensing and insurance, responding to subpoena record requests, printing and enveloping outgoing subrogation mailings, scanning certain incoming mail and helps coordinate corrections for Form 1099-MISC filings as well as the receipt of all Form W-9s and assist with posting SPDs and plan amendments.

ESSENTIAL JOB FUNCTIONS:

Essential job functions include the following. Other functions may be assigned as business conditions change.

• Assists with managing all regulatory licensing for all Allegiance companies and assist with tracking documents and communications with Cigna corporate offices and other Allegiance departments (TPA licenses, individual producer licenses, IUI licenses, ACM licenses) and City of Missoula licenses - tracking applicable deadlines, renewals, etc.
• Assist with providing copies of licenses to eligible recipients when requested.
• Assist with the completion of annual reports required in all states that Allegiance is registered with the Secretary of State and any additional reports required for ABPM, ACSI, ACM and IUI.
• Assist with the renewal of the E&O, Crime and Cyber insurance policies including gathering necessary information required for the applications and helps provide copies of declaration of coverage sheets when requested.
• Assists with the tracking of all Form 1099-MISCs that are returned as undeliverable and assist with sending corrected information to vendors.
• Assist with maintaining file of all Form W-9s received and with updating provider files with Form W-9 information when necessary.
• Assist with risk insurance placement and renewal tracking and interaction with insurance brokers.
• Assists with the submittal of Network Adequacy filings via SERFF (as well as any other SERFF filings that may be required in the future) to State of Montana.
• Assist with the posting and maintaining of all Plan Documents, signed amendments and related group notes (including Pharmacy Import Decision flowcharts and ID card templates, etc.) on MAIN and LIN in the current system and the equivalent in any future system as well as adding notations where necessary.
• Assist with the managing of subpoenas for records including pre-payment estimates, verification of HIPAA authorizations, prints records when all payments/authorizations are received and sending records out.
• Prints and envelops outgoing subrogation mailings.
• Scanning of certain incoming mail.
• Contributes to the daily workflow with regular and punctual attendance.
• Other duties as assigned.

SUPERVISION EXERCISED:

• None

PHYSICAL WORKING CONDITIONS:

Physical requirements are representative of those that must be met to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Sitting 50%

Reaching Medium

Standing 25%

Manual Dexterity High

Walking 25%

Telephone Yes

Kneeling Medium

Computer Screen High (visual acuity corrected to 20/30)

Bending Medium

Lifting up to 20 lbs.

JOB SPECIFICATIONS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Minimum Education: High school graduation or