INSURANCE INVESTIGATOR I/II/III, APPEALS and GRIEVANCE
MIA Officer II
Recruitment #23-009638-0002
Department | Maryland Insurance Administration |
---|---|
Date Opened | 4/26/2023 4:25:00 PM |
Filing Deadline | 5/12/2023 11:59:00 PM |
Salary | Salary Commensurate with Experience |
Employment Type |
Full-Time
|
HR Analyst | Tracey Dailey |
Work Location |
Baltimore City
|
Introduction
The Maryland Insurance Administration (MIA) is
an independent State agency that regulates Maryland’s $46 billion insurance
industry and protects consumers by monitoring and enforcing insurers’ and
insurance professionals’ compliance with State law. Through the diligence
of a highly professional staff of market analysts, financial analysts,
accountants, lawyers, law enforcement officers, actuaries, complaint
investigators, and others, the MIA works to facilitate a strong and competitive
insurance marketplace where consumers are well informed and treated
fairly. Staff members are subject matter experts who serve as a resource
for lawmakers, consumers, and other public and private entities.
The MIA is charged with a broad range of responsibilities including the
licensure of insurance carriers and insurance producers (brokers/agents)
operating in Maryland, the conduct of financial examinations of companies to
monitor financial solvency, and the review and approval of rates and contract
forms. The MIA investigates reports of consumer fraud and consumer
complaints about life, health, automobile, homeowners, and/or property
insurance. Insurance carriers are subject to market conduct examinations
and other actions to monitor compliance with Maryland law. The MIA also
has a unit dedicated to consumer education and outreach, which participates in
hundreds of events and reaches thousands of individual consumers
annually.
*This is a Special Appointment position that
serves at the pleasure of the appointing authority.
GRADE
Insurance
Investigator I, Appeals and Grievance - grade 14 (Starting Salary: $49,403 -
$53,099/year)
Insurance
Investigator II, Appeals and Grievance - grade 15 (Starting Salary: $52,575 -
$80,992/year)
Insurance
Investigator III, Appeals and Grievance - grade 16 (Starting Salary: $55,975 -
$86,450/year)
**Salary Guidelines apply to State employees**
POSITION DUTIES
The MIA’s Life and Health
Division is recruiting for an Insurance Investigator, Appeals and Grievance
positions at the I, II, or III level. This position investigates consumer
complaints regarding the denial of a claim or service based on medical necessity
and determines if the carrier is in violation of the Maryland Insurance
Article. The Insurance Investigator, Appeals and Grievance answers calls
from citizens, attorneys, health providers and others regarding the complaint
process; and responds to emergency calls concerning medical necessity denials.
At scheduled times, this position is required to be “on-call”,
after-hours and weekends, to respond to consumer complaints received by
telephone.
MINIMUM QUALIFICATIONS
Insurance Investigator I, Appeals and
Grievances:
Education: Bachelor’s degree from an accredited college or
university.
Experience: None
Note: Experience in the review of medical records or medical
claims may be substituted on a year-for-year basis for the required education.
Insurance Investigator II, Appeals and Grievances:
Education: Bachelor’s degree from an accredited college or
university.
Experience: Two years of enforcement/investigatory experience
with a regulatory agency, licensed insurer, or accredited law enforcement
agency.
Note:
- Experience in the review
of medical records or medical claims may be substituted on a year-for-year
basis for the required education.
- Possession of a J. D. degree may substitute for the minimum experience requirements.
Insurance Investigator III, Appeals and Grievances:
Education: Bachelor’s degree from an accredited college or
university.
Experience: Three years of enforcement/investigatory
experience with a regulatory agency, licensed insurer, or accredited law
enforcement agency.
Note:
- Experience in the review
of medical records or medical claims may be substituted on a year-for-year
basis for the required education.
- One year of
enforcement/investigatory experience with a regulatory agency, licensed
insurer, or accredited law enforcement agency and possession
of a J. D. degree may substitute for the minimum experience requirements.
BENEFITS
FURTHER INSTRUCTIONS
If you have any questions about this recruitment, please contact
tracey.dailey@maryland.gov.
For immediate consideration, upload one WORD or PDF file, at the
"Resume" tab, that contains:
1. a cover letter stating your interest and specific salary
requirements; and
2. a current professional resume.
If you are unable to apply online, you may submit via mail.
Please be sure to include all documents listed above to ensure timely
processing. Complete application packets may be mailed to:
Maryland Insurance Administration
Human Resources - Recruitment #: 23-009638-0002
St. Paul Place, Suite 2700
Baltimore, MD 21202
Incomplete submissions will not receive consideration.
TTY Users: call via Maryland Relay
We thank our Veterans for their service to our country, and
encourage them to apply.
As an equal opportunity employer Maryland is committed to recruiting, retaining and promoting employees who are reflective of the State’s diversity.