CONSUMER SERVICES OFFICER II

SUMMARY: To conduct appeal hearings and render decisions in accordance with pertinent laws and policies of the Insurance Department. To represent insurance consumers during interactions with carriers and other licensees, and to mediate disputes between carriers and consumers in order to facilitate the receipt of benefit rights and other advantages of insurance policies.

YOUR EXPERIENCE COUNTS: Each additional year of approved formal education may be substituted for one year of required work experience and/or each additional year of approved work experience may be substituted for one year of required formal education.

MINIMUM QUALIFICATIONS:

Education/Experience: Associate's degree and 4 years of experience OR equivalent combination of 6 years of education and experience after completion of high school. Education and experience must include at least 2 years in fact-finding, conducting investigations, legal research, claims adjusting, dispute resolution, settlement negotiation, insurance regulation, or a related field.

License/Certification: None

Other Requirements: None

Trainee Option: Candidates with an equivalent combination of 5 years of relevant education and experience after completion of high school may be considered and hired in ‘trainee status’ for this position.

PREFERRED QUALIFICATIONS:

Knowledge of insurance principles and practices. Knowledge of the scope, content and process of the state regulations and laws relating to insurance. Knowledge of the methods and techniques of field investigation. Knowledge of insurance terminology and the relationship pertaining to the contractual provisions of insurance policies and the payment of claims. Ability to gather information through personal interview of records, correspondence and documents. Ability to objectively evaluate information received and to make sound recommendations. Ability to express ideas clearly and concisely. Ability to maintain effective working relationships with complainants, insurance industry representatives and the general public. Ability to resolve complicated questions of liability and amounts of damages.

AFTER-HIRE REQUIREMENTS: None

RESPONSIBILITIES:

Present and explain complex information regarding federal and state insurance laws and regulations to consumers in a manner which is understandable to individuals who are not familiar with insurance industry terminology and product concepts.

Investigate insurance related grievances and complaints, which allege potential violations of NH insurance laws and regulations, via phone calls, written correspondence, and in-person meetings.

Record and archive investigation data, including summaries of verbal communications and written correspondence, in the Consumer Services Division’s inquiry and complaint database for purposes of tracking and reporting.

Mediate disputes between consumers and insurance carriers, negotiating consumer-friendly resolutions whenever possible.

Prepare reports and present information, summarizing the results of investigations and other actions taken on behalf of consumers to resolve complaints.

Preside at internal departmental hearings on appeals filed by insureds, claimants or complainants, where decisions are based on relevant facts, findings and federal/state laws are made.

Prepare recommendations to refer cases involving violations of NH insurance laws and regulations to the NH Insurance Department’s Enforcement and Market Conduct Divisions for further investigation.

Determine need for informal/formal hearings, schedule hearings and issue requisite notifications to all parties and witnesses.

Confirm or negate previous action taken by licensees, based upon facts presented in internal Departmental hearings.

Issue written decisions to licensees and insureds, claimants or complainants and prepare appropriate communications.

DISCLAIMERS:

The supplemental job description lists the essential functions of the position and is not intended to include every job duty and responsibility specific to the position. An employee may be required to perform other related duties not listed on the supplemental job description provided that such duties are characteristic of that job title.

The work of an employee in trainee status in this position shall be overseen by a fully qualified individual. An employee in trainee status shall meet the minimum qualifications within the period of time specified on the SJD, not to exceed one year of being hired into this position.

For further information please contact:

Katrina Gagne, Talent Acquisition and Payroll Technician

ins-careers@ins.nh.gov

603-271-7075

*TOTAL COMPENSATION INFORMATION

The State of NH total compensation package features an outstanding set of employee benefits, including:

HMO or POS Medical and Prescription Drug Benefits:

The actual value of State-paid health benefits and the amount of employee health benefit contributions may vary depending on the type of plan selected and the bargaining unit with which a position is associated.

See this link for details on State-paid health benefits:

https://www.das.nh.gov/hr/benefits.aspx

Value of State's share of Employee's Retirement: 12.87% of pay

Other Benefits:

• Dental Plan at minimal cost for employees and their families ($500-$1800 value)

• Flexible Spending healthcare and childcare reimbursement accounts

• State defined benefit retirement plan and Deferred Compensation 457(b) plan

• Work/life balance flexible schedules, paid holidays and generous leave plan

• $50,000 state-paid life insurance plus additional low-cost group life insurance

• Incentive-based Wellness Program (ability to earn up to $500)

Total Compensation Statement Worksheet:

https://www.das.nh.gov/jobsearch/compensation-calculator.aspx

Want the specifics? Explore the Benefits of State Employment on our website:

https://www.das.nh.gov/hr/documents/BenefitBrochure.pdf

https://www.das.nh.gov/hr/index.aspx

EOE

TDD Access: Relay NH 1-800-735-2964