Insurance Consumer Analyst I (S) The mission of the North Carolina Department of Insurance is to promote a stable insurance market through unbiased regulation and to protect the lives and property of every citizen in all 100 counties while fostering superior, user-friendly service, courtesy, and respect. Our agency licenses insurance agents, adjusters, bail bondsmen and more, along with investigating fraud matters involving insurance consumers and any entity or individual regulated by the Department. In an ever-changing environment, it is the vision of the Department of Insurance to maintain the stabilization of the insurance industry in order to provide more products, competitive prices and consumer protection.
The primary purpose of this position is to provide counseling, education, and assistance to consumers regarding health insurance issues affecting Medicare beneficiaries through a national toll-free telephone line, in-person meetings, and virtual assistance. This position is responsible for assessing consumers' needs, gathering and verifying accurate information, and providing clear and appropriate responses to questions and inquiries.
The position requires extensive knowledge of Medicare, Medicare Supplement insurance, Long-Term Care insurance, Medicare Managed Care, Medicare Prescription Drug Plans, medical claims procedures, and Medicare fraud, waste, and abuse. When an inquiry requires additional research, the position will refer the issue to the appropriate staff member for further review and coordinate follow-up with the consumer to ensure the question or concern is addressed. The position may also make appropriate referrals to other sources of assistance, including social service organizations, state and federal agencies, and community resources, based on the consumer's specific needs and circumstances.
Management PreferencesStrong knowledge of health insurance laws, regulations, policies, procedures, and Medicare laws and claims practices.
Extensive knowledge of Medicare Supplement, Medicare Managed Care, Medicare Prescription Drug Plans, and Long-Term Care insurance products, including the ability to compare and differentiate among various products to effectively educate, advise, and assist consumers.
Strong communication, organizational, and interpersonal skills, with the ability to accurately assess consumer needs, gather information, document inquiries, and manage follow-up activities.
Demonstrated ability to communicate complex health insurance and Medicare-related information clearly, accurately, and concisely by telephone, in person, and through virtual platforms, primarily to senior citizens and individuals with disabilities.
Demonstrated patience, professionalism, empathy, and courtesy when assisting elderly and disabled individuals, particularly when addressing complex, sensitive, or potentially confusing insurance-related questions and concerns.
Bachelor's degree business or economics or a related program from an appropriately accredited institution and one year of experience in insurance underwriting, claims, or policyholder service; or an equivalent combination of education and experience.
