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Pricing & Review Specialist

Job Title

Pricing & Review Specialist

Job ID

14355

Location

Kingwood Texas

There’s a reason Insperity was ranked in the top 3% on WorkplaceDynamics’ National Top Workplaces list and named one of the top 100 companies to work for in the U.S. 

 

Want to work for us and find out why? 

 

As a trusted advisor to America’s best businesses for more than 35 years, Insperity provides an array of human resource and business solutions designed to help improve business performance. In addition, we provide the client company and their worksite employees with a wide array of value-added benefits and services. 

 

Insperity offers a competitive compensation package and a world-class benefits package, including 19 days paid time off, 9 paid holidays, medical, dental and vision benefits, 401k and tuition reimbursement. At Insperity, we’re committed to providing a positive work environment, and to helping our employees succeed both personally and professionally. 

  

Pricing & Review Specialist

We are currently seeking a Pricing & Review Specialist to join our team.

Analyzes, reviews, and makes final decisions for benefit risk, workers’ compensation risk, and pricing based on review criteria to provide competitive rating for either prospective or existing clients as assigned.
 

PROSPECTIVE CLIENTS – ESSENTIAL FUNCTIONS

Under general supervision and moderate decision-making:

  • Analyzes, reviews, formulates pricing, compares relativity and makes final decisions of medical risk for prospective clients.
  • Analyzes, reviews, formulates pricing and works with Risk Management department to make final decisions for workers’ compensation risk for prospective clients.
  • Analyzes, reviews, prices and completes final determination on Mid-Market prospective clients.
  • Gathers all information for review and pricing for Employment Practice Liability Insurance (EPLI).
  • Analyzes and reviews pricing based on review criteria to provide competitive rating.
  • Recommends safety inspection visits by Safety Consultants to clients with workers’ compensation issues and/or to assist with final review process.
  • Gathers and prepares all information to be submitted to Risk Management Department, workers’ compensation carrier and employment practice liability insurance carrier.
  • Synthesizes “estimates” into “bids” when required documentation has been supplied and reviewed by the Sale Consultants.
  • Enters pricing (workers’ compensation, medical coverage modifiers, SIC code and risk assessments) in Insperity Information Management System (AIMS).
  • Validates and/or adjusts calculated modifiers to not exceed guideline for minimum modifiers.
  • Reconciles current medical billing and census data to validate accurate medical pricing and risk assessment.
  • Presents the Pricing and Review Department overview to attendees of the Initial Sales Training (IST).
  • Interacts with and maintains a productive working relationship with internal and external customers and vendors on a frequent and continual basis.
  • Participates in the development of policies and procedures directly affecting the Pricing and Review Group.
  • Prepares clear, concise and accurate management reports and presentations.

CLIENT RENEWAL- ESSENTIAL FUNCTIONS

  • Analyzes, reviews and compares clients for medical claims, allocations, participation, accuracy of coverage option pricing and vendor data to formulate renewal pricing.
  • Analyzes, reviews and formulates client renewal workers’ compensation pricing to include the overall difference in classification allocation, claims and the client overall allocation.
  • Summarizes medical and workers’ compensation claim information and enters into the client database.
  • Summarizes, combines data and prices client name and/or FEIN changes.
  • Summarizes, averages and prices clients that review/renew together.
  • Conducts pricing re-evaluations.
  • Interacts with and maintains a productive working relationship with internal and external customers and vendors on a frequent and continual basis.
  • Participates in the development of policies and procedures directly affecting the Pricing and Review Group.
  • Acts as back-up to the Manager, Pricing and Review.
  • Prepares clear, concise and accurate management reports and presentations.

OTHER RESPONSIBILITIES

  • Assists in the accomplishment of Insperity Company goals.
  • Helps other employees to accomplish Insperity Company goals.
  • Performs other duties as may be assigned by department supervisor.
  • Participates in the Disaster Recovery plan as required.

EDUCATION / EXPERIENCE REQUIREMENTS

  • High School Diploma or equivalent is required. Associate’s Degree in related field is preferred. 
  • Five or more years of experience in a related field is required. 

KNOWLEDGE / SKILLS

  • Principles, practices, and procedures of Health and Welfare Pricing, including advanced medical terminology, benefits structure, and renewal of existing client base; methods and techniques related to reviewing health and welfare exposure, pricing, and maintaining reports and records.
  • Principles, practices, and procedures of workers’ compensation risk review including knowledge of coverage’s, rating bases, and variations by state; work experience with a variety of risks and industries.
  • Moderate problem solving and decision-making; works accurately and efficiently under narrow time limitations; works independently in the absence of supervision.
  • Strong written and verbal communication skills; and maintains effective work relations with those encountered in the course of employment; frequent and continual client/vendor contact; strong customer service skills.
  • Performs basic business mathematics calculations, strong computer skills including data entry software including SLIS, MS Access, Excel, Word, Windows and other vendor software such as PSM.

HIPAA LEVEL

HIPAA Plan Level identifies if the position is authorized to use and disclose protected health information.

Plan Level 1 – Authorized to use and disclose protected health information for specific purposes, and exchange basic eligibility and enrollment information.

HIPAA Security Level designates a positions access to electronically held protected health information.

Security Level 2 – Permitted “read only” access to protected health information. May only view screens containing protected health information.

This job specification should not be construed to imply that these requirements are the exclusive standards of the position. Incumbent will follow any other instructions and perform any other related duties, as may be required by the supervisor.

 

 At Insperity, we celebrate the diversity of our employees and our leadership. Insperity is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law. 

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