Agent Services Coordinator

Maintains compliance per company and regulatory guidelines which includes monitoring, processing and performing audits agency contracts and agent appointments and terminations for organization and its associates responsible for the sale and marketing of insurance. Responsible for ensuring all aspects of the licensing process are completed within regulatory established time frames. Manages all activities in the contracting process with external agencies as well as administering the organizational continuing education program.

PRIMARY RESPONSIBILITIES

• Facilitates the Agency contracting processes for Dean Health Plan (DHP) and Prevea360. Serves as the primary contact for agency executives throughout the Agency contracting process. Works closely with DHP General Counsel and Director of Legal, in the development of Agency Agreement (contract) rewrites. Develops drafts of amendments to the Agency Agreement following direction from the Manager of Sales Training and Compliance and DHP General Counsel and Director of Legal. Maintain complete and accurate agency records that will be available for internal and external audits (Model Audit Rule – MAR; Centers for Medicare & Medicaid Services – CMS; and the Office of the Commissioner of Insurance – OCI). Contract and compile required information on new and terminated agencies to remain compliant with OCI and IRS document retention requirements. Responds to Agency inquiries regarding commissions and is the point of contact for discrepancies in commission payments.
• Ensures effective handling of all agent licensing activities, including appointments and terminations, by properly complying with and interpreting state insurance licensing rules and regulations. Correspond with state regulators, agency partners and other business partners regarding new appointments and terminations. Monitors, processes and documents sales agent licenses, appointments, terminations, and license renewals. Create and maintain credible and knowledgeable relationship with present and prospective brokers that represent or wish to represent Dean Health Plan/Prevea360 Health Plan in the marketplace. Facilitates the research of electronic files and databases reflecting agent licensing information using multiple internal, vendor, state insurance department systems, and the Federally Facilitated Marketplace. Conduct background checks including OIG/GSA validation on all requests for appointment. Process agent appointments and terminations; ensures that proper paperwork is completed and filed for appointment. Communicates agent appointment status and other information to stakeholders throughout the organization. Maintain complete agent records, through a check/balance procedure, on transactions required for accurate audit results.
• Administers Continuing Education (CE) program for licensed agent related training activities. Expert level knowledge of CE requirements and processes. Submits all CE outlines and instructors to OCI for course approval. Maintains a database of all approved and pending CE courses. Creates certificates of completion and provides copies to all attendees. Reports successful completion of CE course attendees to State approved vendor to track earned CEs. Retains complete records of all attendees.
• Oversight of reporting, audit, and monitoring activities: Perform quarterly audit of licensing activities for compliance with company processes and state requirements. Conduct annual review of agents listed for accurately balancing the OCI annual billing. Weekly review of OCI agent database to identify terminated agents. Monthly review of OIG/GSA database to validate any adverse reports of contracted agencies or appointed agents. Annual verification of agent’s certification to sell on the Federally Facilitated Marketplace. Update agency/agent records and contracting status if adverse information is received.
• Serve as Subject Matter Expert for all agency/agent related activities within organization: commissions system updates (ICM); override tables; agent of record processes.
• Performs other duties as assigned.

EDUCATION

• Associate degree related field, or equivalent years of experience and education

EXPERIENCE

• One year experience in agency licensing

PHYSICAL REQUIREMENTS

• Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.
• Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.
• Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.
• Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.
• Frequent keyboard use/data entry.
• Occasional bending, stooping, kneeling, squatting, twisting and gripping.
• Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.
• Rare climbing.