Jamie Clayton

• Review and approve forms, contracts, endorsements, and policies for life and health, as well as property and casualty insurance products, using knowledge of state and federal insurance law, administrative rules, and procedures; compel the production of supporting records, rates and additional documentation as required. File review requires an in-depth evaluation of the document content based on complex insurance regulations, interpretation of the carrier's intent, and evaluation of the impact for consumers.

• Perform detailed review of submission using extensive knowledge of Title 33 and other relevant Montana and federal laws including but not limited to; Montana Insurance Code Title 33; Title 61 Medicare – Title XVIII, Parts A & B; Medicaid – Title XIX; HIPAA – Health Insurance Portability and Accessibility Act; COBRA – Consolidated Omnibus Budget Reconciliation Act; ERISA – Employment Retirement Income Securities Act; Federal Registry for Medicare and Long Term Care Lines of Insurance, and the Affordable Care Act to determine whether the submis­sion warrants approval for use in Montana and ensuring each form complies with the requirements of those laws.

• Analyze and coordinate correspondence in accordance with statutory filing requirements for Small Employer Health Insurance Availability Act and all forms of insurance as noted in Sections 33-1-206 through 33-1-229 MCA.

• Detect and document evidence of irregularities and non-compliance with statutory requirements.

• Maintain pending files for filings in process. Be cognoscente of delays and tolling of the time it is taking to review the filing.

• Comply with MCA 33-1-501(2)(b)(i) requirement that all submissions be reviewed and approved or disapproved within 60 days of submission

• Effectively communicate with the insurer in writing and orally to advise them of any form provisions that are not compliant with the applicable laws. Provide technical assistance and direction to insurers to bring the provisions of the forms into compliance.

• Record, by company name, the form numbers of approved or accepted forms for verification purposes.

• Notify the insurer of the department’s actions and justify and defend the position taken.

• Apprise Legal Division of consistent attempts to avoid compliance.

• Examine and respond to inquiries from insurance carriers, consumers and other state insurance regulators to ensure all insurance products issued in the state offer protection for Montana consumers by meeting statutory requirements. Responses require an understanding of detailed insurance terms, concepts, and procedures, considerable research, and highly developed communication skills. Maintain computer and physical files related to contract form filing and approval process.

• Maintain files of completed submissions and make available for public inspection.

• Assis­t the public in locating and photocopying approved insurer filings.

• Researched, developed and implemented comprehensive insurance plans for clients according to their individual needs
• Assessed customer risk levels and recommended appropriate coverage options
• Calculated premiums and established payment methods, receiving customers' payments and issuing receipts
• Leveraged customers' history, industry and demographic information to calculate renewal rates
• Prepared documents such as applications, endorsements, renewals, cancellations or other forms required by law or company procedures
• Serviced existing portfolios, assisting members with coverage questions and accurately processing endorsements
• Delivered individualized support and broad knowledge of company products to bring targeted services to individuals with varying needs
• Provided and educated customers with information regarding plan features, pricing and availability
• Responded quickly and accurately to inquiries from clients regarding their coverage plans
• Received underwriting approvals after accurately completing applications for insurance coverages and contacted underwriting to submit forms to obtain binder coverage
• Resolved customer complaints in a timely manner to maintain high satisfaction levels
• Maintained accurate records of all insurance transactions using computer software systems
• Conducted meetings or phone calls with potential clients to present insurance policies and answer questions
• Pursued new clients through various marketing strategies to grow existing portfolio of policyholders
• Generated reports detailing sales activities, client interactions and progress towards goals
• Achieved repeat business and referrals through personalized services
• Met with consultants to discuss strategies to increase sales
• Conducted research to identify competitive rates and benefits offered by other providers
• Monitored market conditions to ensure that existing policies remain competitively priced
• Stayed abreast of industry changes to amend insurance programs for existing and prospective clients
• Remained current on latest industry trends by gaining comprehensive knowledge of financial and insurance products, services and best practices
• Ensured compliance with applicable laws, regulations and company policies while selling insurance policies
• Greatly improved office operation by reducing backtracking or work through creation of material movement process
• Participated in continuing education courses to stay current on industry trends and changes in regulations

• Reviewed and evaluated customer's applications to determine policy pricing according to loss exposure, premium levels and longevity with Montana State Fund
• Investigated discrepancies between application information provided by customers versus third party sources
• Maintained detailed records of underwriting decisions and processes
• Negotiated coverage, policy pricing and service delivery during meetings with customers, agents or brokers
• Conducted periodic reviews of existing policies in order to determine if adjustments are necessary due to changes in customer circumstances or market conditions
• Leveraged customers' history, industry and demographic information to calculate renewal rates
• Evaluated claims data from previous policies to identify trends or patterns that may indicate the trend of risk associated with certain types of policies
• Determined level of risk by reviewing applications for coverage and loss control reports with proper classification of business
• Entered and maintained risk information in various information systems
• Applied rating to encourage safe, profitable distribution of risks
• Ensured compliance laws, regulations and company policies while selling insurance policies while identifying opportunities to improve underwriting processes or procedures
• Developed and maintained relationships with accounts to ensure customer satisfaction
• Developed relationships with brokers, agents and external partners who may refer potential customers
• Monitored industry news and developments that could affect the company's underwriting practices and strategies
• Attended professional development courses related to insurance underwriting best practices

• Answered incoming calls and emails, providing frontline customer support or assistance with product and service transactions
• Maintained detailed records of customer interactions, transactions and comments
• Informed customers about billing procedures, processed payments and provided payment options setup assistance
• Made outbound calls to obtain account information and updated databases with new and modified customer data
• Asked probing questions to determine service needs, accurately input information into electronic system and conferred with customers by telephone or in-person to provide information about products or services
• Set up and activated customer accounts
• Presented existing and prospective customers with valuable service or product information to aid in decision making
• Enhanced productivity and customer service levels by anticipating needs and delivering outstanding support
• Developed strong relationships with customers by providing personalized assistance and support
• Provided outstanding service to new and long-standing customers by attending closely to concerns and developing solutions to encourage repeat business
• Remained calm and professional in stressful circumstances and effectively diffused tense situation with excellent communication skills
• Promoted high customer satisfaction by resolving problems with knowledgeable and friendly services in a timely manner
• Escalated customer concerns, issues and requirements to supervisor for immediate rectification
• Resolved complex problems by working with other departments to provide solutions that meet customer needs
• Identified areas of improvement in customer services processes and suggested changes accordingly
• Mentored new employees on procedures and policies to maximize team performance

• Answered incoming calls and emails, providing frontline customer support or assistance with product and service transactions
• Performed administrative tasks such as filing paperwork, updating databases and generating reports
• Maintained detailed records of customer interactions, transactions and comments
• Made outbound calls to obtain account information
• Set up and activated customer accounts
• Assisted customers with making payments or establishing payment plans
• Answered customer inquiries and provided accurate information regarding products and services
• Developed strong relationship with customers by providing personalized assistance and support
• Promoted high customer satisfaction by resolving problems with knowledgeable and friendly services in a timely manner
• De-escalated problematic customer concerns, maintaining calm, friendly demeanor

• Analyzed quality assurance data to identify trends and develop and implement corrective actions plans
• Used quality monitoring data management systems to compile and track performance at team and individual levels
• Identified areas of improvement within the Quality Management System
• Determined training needs of staff and organized training interventions to achieve quality standards
• Collaborated with cross functional teams across the organization to ensure adherence to quality objectives
• Assisted in developing training materials related to quality assurance topics
• Partnered with training and operational leaders to develop strategies to enhance customer experience
• Consulted with management and personnel to educate on QA standards
• Monitored QA procedures for adherence by employees, notifying personnel of non-compliance issues
• Learned new testing methods through continued education and research

• Answered incoming calls and emails, providing frontline customer support or assistance with product and service transactions
• Engaged in conversation with customers to understand needs, resolve issues and answer product questions
• Provided outstanding service to new and long-standing customers by attending closely to concerns and developing solutions
• Kept records of customers interactions or transactions, thoroughly recording details of inquiries
• Presented existing and prospective customers with valuable service or product information to aid in decision making
• Demonstrated excellent communication skills in resolving product and consumer complaints while maintaining calm and professional
• Promoted high customer satisfaction by resolving problems with knowledgeable and friendly services in a timely manner
• Referred unresolved customer grievances to designated departments for further investigation
• Mentored new employees on procedures and policies to maximize team performance
• Identified areas of improvement in customer service processes and suggested changes accordingly