JOB TITLE: INSURANCE MARKET CONDUCT EXAMINER TRAINEE

JOB CODE: 04094

SERIES NATURE OF WORK: The Insurance Market Conduct Examiner job series describes work in the regulation of market conduct activities of insurance companies and other licensees of the Pennsylvania Insurance Department.

DEFINITION: This is a 12 month structured training program to develop the knowledge and skills needed to examine insurance company and insurance licensee operations to determine compliance with market conduct laws and regulations.

An employee in this job participates in training assignments designed to develop competency in market conduct examinations to detect unlawful practices and trends related to underwriting and claims practices, advertising and billing procedures, policy form filings, licensing, and consumer complaints. Work involves participating in the examination, verification, and analysis of licensee records and observing and participating in on-site examinations of insurance company operations to learn operational auditing techniques; become familiar with market conduct activities and insurance principles and practices; and develop an understanding of insurance laws, rules, and regulations. Training consists of formal, informal, and on-the-job training provided by the supervisor or a higher level Insurance Market Conduct Examiner. Work is performed with greater independence as learning progresses and examination proficiency is acquired. Work is performed under close supervision by a Market Conduct Examination Chief who assigns projects, provides preliminary instructions, and closely reviews work in progress and upon completion for quality, adherence to established standards and instructions, and professional development.

EXAMPLES OF WORK: (NOTE: The examples of work are representative of the work, but every position classified to this job may not perform all examples of work listed. Conversely, this is not an all-inclusive list of work examples.)

• Assists with preparing preliminary data requests for insurance companies or licensees selected for examinations.

• Reviews documents and data submitted by insurance companies and other licensees to determine compliance with policies and procedures and documents findings.

• Researches insurance statutes and other sources to determine what penalties can be assessed against insurance companies and other licensees for non-compliance with commonwealth insurance laws.

• Assists in preparing various reports throughout the examination process.

• Participates in oversight of targeted examination results by reviewing insurance companies’ and other licensees’ reports of restitution, claims payments, and other documents to facilitate and ensure implementation of agreed-upon resolutions to violations of commonwealth insurance laws.

• Participates in training seminars, studies training materials, and presents detailed reports on training assignments.

• Travels to insurance company sites inside and outside of Pennsylvania to participate in market conduct examinations.

• Performs related work as required.

ENTRY LEVEL KNOWLEDGES, SKILLS, AND ABILITIES:

• Knowledge of the principles and practices of business administration.

• Knowledge of analytical and evaluative methods and techniques.

• Knowledge of the use and functionality of Microsoft Office Suite software.

• Ability to analyze and interpret laws, rules, regulations, policies, and procedures.

• Ability to read and interpret written and numerical information.

• Ability to prepare clear and comprehensive written reports.

• Ability to communicate effectively orally.

• Ability to communicate effectively in writing.

• Ability to establish and maintain effective working relationships.

MINIMUM EXPERIENCE AND TRAINING: (NOTE: Based on the Entry Level Knowledges, Skills, and Abilities)

• A bachelor’s degree in insurance, risk management, business administration, public administration, public policy, finance, economics, accounting, or a related area;

or

• Four years of paraprofessional experience in insurance, risk management, business administration, public administration, public policy, finance, economics, or accounting;

or

• An equivalent combination experience and training.