MICA remains committed to creating an inclusive environment that values and respects the diverse talents, skills, and backgrounds of everyone. We celebrate both our differences and our similarities as we focus on service to our members and foster shared opportunities in furtherance of MICA's mission.
MICA features a challenging and professional work environment characterized by open communication, business casual working attire and flexible work schedules. We always welcome inquiries regarding employment opportunities with the company.
We offer a competitive compensation package and a comprehensive benefits program that supplements our pro-active employee focus. We also support professional growth opportunities to ensure employees are equipped with the knowledge, skills and abilities to provide exemplary client service.
Role Overview
The Claim Representative is responsible for investigating, managing, and evaluating minimal to high exposure claim and suit files in accordance with Claim Department Guidelines, to include identifying coverage issues, setting adequate reserves, assessing degree of liability, and determining case value. The Claim Representative brings cases to a satisfactory close, to include negotiating settlements. The Claim Representative works closely with the assigned supervisor.
Responsibilities
- In the interest of cybersecurity, the Claim Representative is responsible for being cautious and vigilant when opening emails, attachments etc. on MICA’s equipment, and smartphones that are connected to MICA’s email systems. Likewise, it is the Claim Representative’s responsibility to complete cybersecurity training modules that are periodically distributed by MICA’s IT department.
Initial Claim Handling:
- Take first notices.
- Review first notice and instructions (and Summons & Complaint when applicable).
- Review claim for potential coverage issues.
- Discuss questions on claim handling and coverage with supervisor, as necessary.
- Select defense counsel with appropriate supervisory input and after discussion with Insured.
- Make service provider and reserve recommendations.
- Prepare correspondence to Insured and counsel.
- Report claims to NAS and/or regulatory Boards, if appropriate.
Claim File Work-up:
- Obtain and appropriately organize medical records.
- Review medical records and appropriate literature.
- Interview Insured and prepare interview summary.
- Interview unrepresented claimants and prepare summary.
- Obtain/review pertinent records of subsequent treating physicians, as necessary.
- Select and approve standard of care and causation consultants.
- Attend key depositions.
- Discuss defense strategy with assigned counsel.
- Prepare file for 90-day supervisory review by identifying liability issues and damages, considering reserves, and act on requests for follow up.
- Obtain information on liens and Medicare Right of Recovery.
- Monitor reserves.
- Prepare timely reports to management and/or reinsurers.
- Evaluate defensibility, verdict range and settlement value.
- Prepare and present appropriate cases to management for settlement authority.
- Make timely and accurate claim file entries documenting developments.
- Enter pertinent information into the data-capture systems.
- Promptly review, code and pay bills.
Claim Resolution:
- Discuss settlement with Insured and obtain proper written consent.
- Log all trial and mediation dates into the data capture system.
- Prepare Request for Authority and present at the appropriate management level.
- Attend MICA Authority Committee Meeting, if necessary.
- Prepare strategy for negotiations.
- Attend mediations or negotiate directly with the claimant or claimant’s attorney.
- Prepare and present pre-trial report.
- Monitor trial and notify management of pertinent developments.
- Prepare check request for trial reimbursement to insured.
- Prepare indemnity check request and routing instructions.
- Enter settlement, verdict and/or expert information into the data capture system.
- Prepare accurate report to the National Practitioner Data Bank, for supervisory review.
- Report settlement to appropriate regulatory entity and/or Medicare, if appropriate.
- Obtain copy of Release, Dismissal and final bills.
- Send closing letter to Insured.
- Timely close file after final payments, reports and closing documents are received.
Requirements
- High School diploma or GED; Bachelor’s degree preferred.
- Minimum of 3 years, progressively complex casualty/property claims experience.
- Must demonstrate good judgment.
- Excellent oral and written communication skills.
- Well organized and detail oriented.
- Able to work independently in a telecommuting environment, if appropriate.
- Able to develop effective working relationships.
- Able to keep sensitive information confidential.
- Working knowledge of personal computers and computer applications.
- Must have a valid driver’s license, and must be able to meet MICA’s insurability requirements.
- Field experience preferred.
- 25% travel required.
Role Overview
The MICA Underwriter is responsible for underwriting MICA new and renewal business in accordance with the MPL rating rules, Underwriting guidelines, procedures and service standards The Underwriter will interact with MICA customers to service and retain the assigned book of business This position must work effectively with all other departments to meet company goals The Underwriter must be able to manage multiple assignments and prioritize work, tasks and schedules
Responsibilities
- Evaluate new and renewal MICA business within delegated authority levels and underwriting guidelines
- Make effective and efficient underwriting decisions within underwriting authority based on the analysis conducted for solo physician practices, physician groups, and advanced health care professionals Refer rating recommendations of those accounts outside of authority levels to management
- Maintains policy documentation to support recommendations and decisions
- Prioritizes tasks to meet renewal deadlines and customer service standards
- Demonstrate an understanding of the MICA MPL rating rules, policy forms, and guidelines
- Analyze loss information to evaluate trends in individual and group accounts
Identify high risk accounts for additional review and underwriting action (TBRs) - Demonstrate proficiency in Oasis, OnBase, and Microsoft Office
- Establish and build relationships with policyholders in the assigned book of business
- Ability to work independently in a dynamic, rapidly changing environment while meeting department service standards
- Work effectively with other departments to align with company goals
- Assist other team members in handling accounts, as needed or in cases of long-term absences
- Participate in continuing education classes/seminars/conferences
Participate in special projects as assigned
Cybersecurity compliance
Other duties as assigned
Requirements
- Insurance experience of 1-3 years preferred.
- Strong oral and written communication skills, attention to detail and accuracy in work product.
- Sound analytical skills to interpret data, make sound decisions and present solutions.
- Self-motivated and able to accomplish multiple tasks within deadlines.
- Experience with Microsoft Office, automation systems including database and document/records management systems.
- Highly organized, disciplined and able to handle workload within established time frame parameters.
- Team player.
- Degree or professional certifications preferred.
Role Overview
Based in Phoenix, Arizona, the VP of Underwriting provides the leadership necessary to ensure the overall operation of the Underwriting Department. The Vice President is responsible for promoting a desired book of business by recommending and maintaining appropriate underwriting standards, managing client and broker relationships, and providing technical support to attract and retain business. The Vice President will ensure the appropriate staff, skills and capabilities are in place to ensure effective, consistent, and efficient underwriting operations and is responsible for developing underwriting personnel. Oversees the customer service function and ensures the quality of service to all customers is meeting or exceeding MICA’s standards.
Additionally, as a member of the leadership team, the Vice President works to ensure the organization achieves its strategic direction, i.e., implementing team goals, supporting the company’s strategies, exemplifying MICA’s core values, etc. The VP is responsible for related goal setting, planning, problem solving, leading, and fostering interdepartmental communication and collaboration.
Responsibilities
Executive Leadership
- Leads and manages the Underwriting operations consistent with MICA’s strategic initiatives, core values and business philosophies.
- Acts as a strategic partner on the leadership team and collaborates with team members to develop Strategic Plans for the organization.
- Works with leadership team members to execute tactical plans aligned with strategic objectives, budgets, and timelines.
- Ensure key execution targets are met and lead teams to develop sophisticated solutions to challenges along the way.
- Making recommendations and/or reporting to the Board and Board Committee(s) on various matters, including to underwriting decisions, rate analyses, and business development
- Represent MICA with policyholder members and business
- Be an engaged ambassador of MICA and build strong relationships at all levels, internally and
- Works closely with the CEO and COO to define underwriting strategy and recommend business plans that will generate profitable, sustainable business in current and future markets.
- Attend MICA Board meetings as requested by CEO and make appropriate presentations or recommendations for action.
- Acts as a voting member of the Underwriting Management Review Committee and supports the Committee Chair in fulfilling its charter.
Management:
- Ensures appropriate staff, skills and capabilities are in
- Develop and manage underwriting revenue and expense
- Identify, design, and implement processes to improve policyholder satisfaction, quality, efficiency, and productivity.
- Works closely with IT to ensure operating systems are effective and Spearheads system improvement initiatives for underwriting and customer service. Influences billing system initiatives.
- Helps ensure rate adequacy, pricing practices, and regulatory compliance in each jurisdiction. Oversees the development and use of various pricing models for complex or large Works closely with third-party actuaries.
- Develops and enhances policy forms, including operational
- Develops underwriting rules and assures appropriate application
- Demonstrate/model the company’s organizational philosophy and Code of Conduct
- Encourage successful team development by actively involving team members in planning, decision- making and solving team conflicts.
- Act as company representative for state regulators and rating Responsible for rate, rule, and form filings with regulators.
- Review and negotiate contracts, including broker contracts and Ensures compliance with terms and conditions.
- Demonstrate advanced knowledge of the various healthcare product
- Maintain and foster relationships with MICA appointed brokers and direct
Engagement:
- Attend and engage in MPL and other member organizations as well as participate in community events as a MICA leader.
- Engage in various industry meetings, actively representing MICA and providing leadership to various initiatives as appropriate.
- Monitors and analyzes competitor landscape, market trends, and regulatory Proactively develops and implements underwriting strategies accordingly.
- Make presentations stating the case for support, engagement, or objectives of MICA, articulating the underwriting strategy and outcomes to various constituencies.
Manage and cultivate existing relationships with strategic stakeholders, including our actuaries, trade associations, regulatory authorities, and reinsurance partners.
Requirements
- Undergraduate and/or advanced degree in business or a related field strongly
- CPCU and/or RPLU designation
- Ten (10) or more years of progressively responsible experience managing Underwriting
- Experience working effectively with a board of trustees or
- In-depth understanding of the industry including insurance operations, preferably MPL, regulatory requirements, risk management, and compliance.
- Demonstrated strategic leadership ability, executive skills, and process
- Strong business development oversight skills
- Excellent presentation and communication skills
- Strong analytical, organizational and process skills
- Strong decision-making and critical thinking skills
- Medical, Dental, and Vision Insurance
- Flexible Spending Accounts
- Basic Employee Life Insurance - paid 100% by MICA
- Optional Life Insurance
- Personal Accident Insurance
- Short- and Long-term Disability
- Self-directed 401(k) with a generous company matching program
- Defined benefit retirement plan
- Paid vacations and holidays
- Tuition Reimbursement for approved educational courses
- Employee Assistance Program
- Relocation Assistance for certain positions
- Insurance coverage is offered for employees, family members, and partners.
Bring your talents to MICA. We recognize that the best-qualified individuals, contributing their ideas and expertise, will enable us to continue our successful support of the healthcare community.
Disclaimer: The benefits identified herein and the eligibility of employees, family members, and partners are governed by the applicable plans. The company, in its sole discretion, and in accordance with applicable law, reserves the right to change and/or delete any or all of the above-listed benefits at any time.
This link leads to the machine-readable files that are made available in response to the federal Transparency in Coverage Rule and includes negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine-readable files are formatted to allow researchers, regulators, and application developers to access and analyze data more easily.
NOTE to employment agencies and search firms: Please do not forward resumes to this website. Your company's literature may be sent to MICA at the following address. MICA will not be responsible for any fees arising from the use of resumes received through this site.
Note to applicants and employment agencies: General letters of intent without a detailed resume will not be considered. MICA will also not consider unsolicited letters of intent with or without resumes.
MICA is an Equal Opportunity Employer.