SUMMARY:   The Medical Only Claims Specialist II is an experienced level claims role. The incumbent is expected to perform at a high level with minimum supervision. Primarily responsible for the investigation and management of workers’ compensation claims. Conducts one point contact on the managed claims, determines compensability of claims, manages the medical treatment program, and confirms the claimant’s disability will not exceed waiting period timelines.  This includes calling and discussing potential claim activity and work-related injuries with policyholders, and claimants, providers, attorneys, agents, and state agencies, when necessary.   ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned. Investigates workers’ compensation claims including a mandatory contact to the employer within the required time frame with additional contacts to the employee or provider, as necessary.   Inform medical providers of billing address and billing...

SUMMARY:     This position is responsible for the indexing of all incoming documents to core business units of the company.  Documents are received via paper, fax, and email.  The incumbent must distinguish what department a document belongs to, apply proper criteria to electronically route the document into an electronic database, and initiate workflow of these documents to appropriate core business units in an accurate and timely manner.  Primary contacts include other departmental personnel.     ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.   Opens, sorts, prepares, bundles, scans, and validates/verifies physical and electronic mail for all departments daily.   Determine appropriate criteria to accurately index an electronic image to initiate workflow to the proper department.   Performs data entry updates to tracking log for all returned Claims issued checks....

SUMMARY: Reviews, analyzes, approves or rejects complex business within letter of authority. Serve as liaison with company personnel regarding company business opportunities and problem resolution. Responsible for providing temporary assistance to field BDC and providing input when requested as part of the territory’s or regions overall agency plan.   RESPONSIBILITIES / TASKS: Calculates, prepares and develops premium quotations using corporate underwriting guidelines within letter of authority Determines underwriting eligibility for prospective policyholders and develops appropriate pricing for new business, renewals, and endorsements Analyzes and reviews prospective accounts for insurability and accepts or rejects within letter of authority. Supports agency relationships. Supports agency plans in cooperation with other staff. Addresses agents’ and policyholders’ concerns/needs. Develops new business and retention...

SUMMARY:  Primarily responsible for supporting the management of the claim files by analyzing, indexing, re-indexing, and assigning a sub document type to all documents received by the Claims Departments within the Enterprise. Also responsible for identifying key information on documents and inputting information into the keywords of the document and in the appropriate data fields in the claim system.   ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.   · Analyzes incoming documents and assigns the appropriate document sub type to them · Reviews each document and adds pertinent information to the document keywords and to appropriate data fields in the claim system · Re-indexes and appropriately routes documents that have been assigned an improper document type or have been attached to an incorrect claim · Sets priority activities to claim handlers as appropriate upon receipt and review of documents · Performs other duties and...

SUMMARY: The Principal Data Scientist is a highly experienced individual contributor who serves as a technical authority in applying advanced analytics and machine learning to complex P&C insurance problems, including underwriting, pricing, and risk selection. This role owns the end‑to‑end analytical lifecycle, from problem formulation and model development through deployment, monitoring, and governance. Partners closely with Actuarial, MLOps, and IT to deliver scalable, production‑ready solutions. The Principal Data Scientist ensures long‑term model performance through rigorous validation, drift monitoring, and audit‑ready documentation, while advancing analytical best practices and evaluating emerging techniques relevant to commercial P&C insurance. RESPONSIBILITIES/TASKS: Acquires,  organizes, and cleanses structured and unstructured data. Conducts in-depth analysis to uncover trends, risks, and business opportunities. Applies statistical...

Responsible for leading the development and implementation of programs and strategies by identifying insights that enhance business decision making capability. This includes developing or changing workflows and implementing process improvements to enhance organizational products, programs and service to our customers. Identify and analyze operational data and develop insights in support of business objectives. Develop and improve work flows and business processes within defined areas to improve customer service, decrease operational costs and improve overall quality. Identify and/or analyze business problems and develop recommendations for solutions to problems. Lead the development and implementation of projects and/or teams in order to produce desired results. Document and communicate project concepts, milestones and results. Recommend and assist with implementing standard policies and procedures. Ensure that corporate compliance is communicated, implemented and...

This role is responsible for advancing and sustaining enterprise learning and development programs in support of employee and leader growth based on our values and leadership competencies. Reporting to the Director, Learning, Culture, and Organizational Development, this position is responsible for the planning, development, evaluation, and execution of multiple learning and development initiatives. This position will have a focus on enterprise learning initiatives and contribute to driving cross-enterprise alignment. Leads the design, development, execution, and continuous improvement of enterprise learning and development programs that advance employee and leader capability, reinforce organizational values, and support leadership competencies.  Oversees multiple, high-impact enterprise-wide learning initiatives (including Leadership Learning Series, Developing You, CareerFocus, CareerCoach, and Project Management Essentials), ensuring consistency, quality, and measurable...

Perform technology functions to include but not limited to business and systems analysis, application development and process improvement. Serve as a liaison between the business area and the IT organization when needed. Identify, document and communicate system and process changes necessary to improve system and operational performance measures.  Possess an in-depth knowledge of line of business while contributing to the identification, analysis and recommendation of technical process improvement initiatives. Design, create and implement technical solutions. Support complex business processes. Conduct data gathering and analysis to understand business strategy requirements. Provide direction for short and long-term planning sessions and provide direction to ensure understanding of business goals and direction. Evaluate ongoing department activity and propose new tools or technologies Assist in the business process redesign and documentation as needed for new technology....

Responsible for promoting appropriate benefit designs for prescription drugs to sales staff, agents and customers.  This position is also responsible for the education of sales staff and agents regarding the available benefit designs in order to advance corporate efforts to increase market share and provide cost-effective benefit designs.  The incumbent responds to RFP's, RFI's and questionnaires for prescription drug benefits. Prepare and conduct presentations or educational programs to various audiences, including customers, agents and internal marketing departments.  Provide accurate and timely responses to prescription drug Requests for Proposal (RFP), Requests for Information (RFI) and Questionnaires for both local and national groups.  Coordinate with BCBSM prescription drug vendor to compile RFP, RFI and Questionnaire responses that are the vendor's responsibility.  Review prescription drug RFP, RFI and Questionnaire responses compiled by other corporate...

SUMMARY   Provides leadership and direction to the Service Center Team to ensure that the goals and standards of the department and Accident Fund are being met.   Facilitates the development of cross-functional work teams within the Service Center.   Participates in ongoing development of new products and technologies. Ensures productivity meets or exceeds service and quality standards. Develops departmental budget and controls costs.   ESSENTIAL DUTIES AND RESPONSIBILITIES  include the following. Other duties may be assigned. Plans, directs, manages and evaluates the day-to-day operations and workflow of a multi-functional and multi-state team of representatives that handle underwriting, billing and policy inquiries.  Approves/Declines underwriting, audit and billing referrals. Has overall accountability for the accuracy and timeliness of premium billings agent commissions and collections. Provides analysis and recommendations as requested by leadership...

Responsible for retention activities for BCBSM and/or BCN customers generally with 50 to 99 contracts in a group within an assigned geographic area working in close coordination with Client Engagement Manager and Client Operations Managers overseeing the agent relationship(s) associated with those accounts.  Retention activities include planning, strategizing, benefit consulting and administration to increase membership as well as required resell activities.  Responsibility may include enrolled and prospective customers. Working in concert with the Sales Manager to propose specific retention strategy that is aligned with the overarching strategy for that agency relationship, by understanding the decision-making process and gaining trust and respect from key agent decision makers. Provide the agent/customer with information related to alternate methods of health care delivery (e.g., HMO, POS, PPO).  May include financial alternatives such as funding options. Use...

The Customer Service Representative plays a key role in delivering exceptional service in a fast-paced Call Center setting. This role involves assisting policyholders, agents, brokers, and Ameritrust Service Center team members with inquiries related to billing, premium audits, claims, and policies. CSRs are expected to manage multiple system applications simultaneously while providing efficient and effective support to customers. Experience with handling a variety of digital tools and addressing customer needs across different platforms is essential for success in this position. ESSENTIAL FUNCTIONS: Address inquiries received via phone, chat and email concerning direct bill invoices. Supply policyholders and agents with direct bill history upon request. Process policy modifications for accounts within our direct written programs and assist customers with requests related to payment plan adjustments, premium transfers or waivers, and refund processing. Respond to questions...

This position serves as a technical expert in the claim handler career path.  Under limited supervision, handles claims with litigation, complex/catastrophic and/or coverage elements. Handles the most unique cases, where little precedence has been established.  May handle the most complex, high touch or labor-intensive customers.  Serves as a department leader by developing other employees and may function as acting manager in the absence of department management.  Independently administers complex claims and catastrophic exposures within authority, including claims from dedicated large accounts. Establishes timely and appropriate reserves based on claim profile and anticipated financial exposure. Represents the Company by working closely with customers, agents and brokers to resolve the most complex claim issues. Negotiates settlements with attorneys or injured and exercises independent judgment to settle cases prior to mediation or litigation. Manages outside vendors to...

The Customer Service Representative plays a key role in delivering exceptional service in a fast-paced Call Center setting. This role involves assisting policyholders, agents, brokers, and Ameritrust Service Center team members with inquiries related to billing, premium audits, claims, and policies. CSRs are expected to manage multiple system applications simultaneously while providing efficient and effective support to customers. Experience with handling a variety of digital tools and addressing customer needs across different platforms is essential for success in this position. ESSENTIAL FUNCTIONS: Address inquiries received via phone, chat and email concerning direct bill invoices. Supply policyholders and agents with direct bill history upon request. Process policy modifications for accounts within our direct written programs and assist customers with requests related to payment plan adjustments, premium transfers or waivers, and refund processing. Respond to questions...

This Senior Trucking Insurance Underwriter (Senior Business Development Consultant) position is responsible for the development and management of independent agency relationships within our commercial trucking line, including the development of new business and retention of existing business in a region or territory.  Reviews, analyzes, approves or rejects complex business within letter of authority.  Serve as liaison with company personnel regarding company business opportunities and problem resolution.  RESPONSIBILITIES/TASKS: Calculates, prepares and develops premium quotations using corporate underwriting guidelines within letter of authority. Determines underwriting eligibility for prospective policyholders and develops appropriate pricing for new business, renewals, and endorsements. Analyzes and reviews prospective accounts for insurability and accepts or rejects within letter of authority. Develops and manages agency relationships. Develops agency plans in...

Responsible to write, edit and proofread content for a variety of internal and/or external communications.   Write clear and compelling content while maintaining a consistent brand voice. Proofread internal and external communications content for clarity, tone, style and grammar to ensure communications are high quality and results oriented. Research and produce communications content that is informational, educational and drives engagement. Develop and deliver presentations to internal team members and leadership.   Research targeted audiences and suggest communication channels. Support special projects as assigned.   Generate ideas to improve communication processes and delivery methods. Maintain an understanding of the corporate communications strategy and standards to support the development of communication plans that support strategic initiatives.   Department Summary:   Design and produce branded assets for social media...

Responsible for assisting and supporting management in the evaluation, recommendation, establishment, implementation and analysis of new and improved production workflows, work processes for systems, reporting and new products/programs to improve customer service levels and overall quality. Support the development, coordination, and implementation of projects to enhance the overall efficiency of operational procedures, methods, controls, and performance. Compile and analyze operational data to identify and resolve business problems. Utilize and maintain available reporting systems. Participate in systems testing, develop procedures/controls and provide recommendations for the ongoing improvement of the updated process. Provide leadership team with status updates on projects and issues. Communicate and recommend policy changes to achieve project objectives. Assist in documenting departmental procedures. Create and present reports and presentations to display operational...

This Trucking Underwriter (Business Development Consultant) position is responsible for the development and management of independent agency relationships within our commercial trucking line, including the development of new business and retention of existing business in a region or territory.  Reviews, analyzes, approves or rejects complex business within letter of authority.  Serve as liaison with company personnel regarding company business opportunities and problem resolution.  RESPONSIBILITIES/TASKS: Calculates, prepares and develops premium quotations using corporate underwriting guidelines within letter of authority. Determines underwriting eligibility for prospective policyholders and develops appropriate pricing for new business, renewals, and endorsements. Analyzes and reviews prospective accounts for insurability and accepts or rejects within letter of authority. Develops and manages agency relationships. Develops agency plans in cooperation with other staff....

The Sr Tax Accountant is responsible for monitoring the company's compliance with tax laws and regulations and assists with the timely completion and filing of the federal and state consolidated tax returns. Prepares monthly, quarterly, and annual tax provisions. Informs management on new tax laws, tax updates and their potential impact. Assists with corporate audits and recommends and implements methods and procedures to minimize tax liability or promote tax savings. Coordinates the activities and functions of area or section including but not limited to planning, organization, problem solving and communication. Close interaction with personnel and management within or outside department in performing duties and assignments. Leads projects sponsored by the Corporate Tax department. Identifies and manages projects issues and risks to facilitate resolution. Develops and maintains cross functional business readiness, communications, and training plans for assigned projects. Assist...

The Actuarial Consultant is responsible for the initiation, organization and analysis of non-routine actuarial research used for analysis including but not limited to valuations, financial reporting and forecasting, trend analytics, and pricing. Utilize advanced actuarial concepts to design and perform complex analysis, conduct research and make recommendations to leadership.  Ensure completeness, accuracy and appropriateness of all insurance data used in the production of outputs; recommend improvements to data as needed.  Independently recommend specific course of action; consider internal, external and customer impacts. Independently communicate to stakeholders.  Define scope of major projects and coordinate completion.  Assess and implement efficiency enhancing processes where available.  Respond to requests from internal departments; prioritize and review work of peers for actuarial soundness.  Drive key department processes. May provide technical guidance to and...