Case Review Officer Jobs (NOW HIRING)

About the Organization:

The Division of Insurance ("DOI"), an Agency within the Office of Consumer Affairs and Business Regulation, administers the Commonwealth's insurance consumer protection laws through its regulation of the insurance industry. The primary mission of the Division is to monitor the solvency of its licensees in order to promote a healthy, responsive and willing marketplace for consumers who purchase insurance products. The Division also investigates and responds to consumer inquiries and complaints, enforces state insurance laws and regulations, and provides the public with accurate and unbiased insurance information. An important aspect of the Division's work is ensuring that the individuals and business entities conducting the business of insurance in Massachusetts do so in a legal and timely manner.

The Division of Insurance is committed to creating and sustaining a work culture that is welcoming, inclusive, and mutually respectful to all its employees regardless of race, color, age, creed, religion, national origin, ethnicity, sex, gender identity or expression, sexual orientation, genetic information, veteran or disability status. We strive to reflect diversity in all facets and levels of our agency. The Division of Insurance values inclusiveness and diversity within their employee and management teams. Within our community we strive to create and maintain working and learning environments that are inclusive, equitable, and welcoming.

The Division of Insurance is committed to ensuring a diverse and inclusive workplace where all employees feel respected, valued, and empowered to maximize their skills and talents to serve our citizens.

About the Role:

The Administrative Review Officer II is responsible for facilitating administrative hearings related to appeals of automobile insurance surcharges. This role involves conducting administrative hearings virtually or in whatever format is determined by the managing body of the Division of Insurance as it relates to the Board of Appeal. The review officer collects, reviews and manages any and all evidentiary materials submitted by all parties, ensuring that each case is considered thoroughly and that grievances are addressed throughout a fair and equitable review process.

In addition, the Administrative Review Officer participates in training and implementation efforts related to new technologies, policies and procedures as needed to accomplish those goals as initiated by management of the Division of Insurance. This role supports the ongoing modernization of hearing processes and ensures compliance with updated operational requirements and administrative guidelines.

Duties and Responsibilities:

Conduct administrative hearings either virtually, via telephone conference or in person, involving appellants and/or Counsel appealing At-Fault Accident Determinations applied under the individual "Merit Rating Plans" of insurance companies. Ensure the collection, organization and storage of all insurance of all files, evidence and other materials/information submitted by the parties for each hearing. Review all evidentiary material or information presented by the parties for each hearing. Issue and distribute written decisions in the required format based on the applicable/governing laws, regulations and facts presented, in accordance with 211 CMR 74.00 and 211 CMR 88.00. Compile and maintain the evidentiary record for each hearing as required by current general record keeping laws and guidelines.

The administrative hearing process includes, but is not limited to, the following duties

• Prepare for hearings by researching and reviewing all documentation.

• Ensure hearing dockets are properly prepared and contain accurate Appellant, appeal and docket information, along with all submitted evidence and associated insurance files in the designated folder system.

• Verify that the Microsoft TEAMS (or other virtual application) environment is operational and that the telephone call-in/out system is functioning properly prior to the start of the hearings.

• Conduct hearings virtually, in-person or by written submission, if requested.

• Convene the hearing and identify persons present. Swear in witnesses before testifying.

• Ensure that all Appellants who have attempted to connect to the hearings and were not admitted are contacted using the TEAMS application to allow them to participate in their hearing

• Maintain a fair, open-minded, and impartial attitude when conducting hearing(s)

• Be clear and direct, but considerate of counsel, parties, witnesses, and others in hearings.

• Provide ample time for insurance representative(s) to read each files into the record.

• Permit the appellant and witnesses ample time to present their case.

• Ensure participants in the hearing identify exhibits for the record when they are introduced.

• Review all evidence, including any records, investigations, reports, and documents to be relied upon in making a decision and made a part of the record.

• Identify any procedural errors and determine if action is warranted.

• Review documentation after a hearing has concluded to determine whether conclusions are consistent with previous rulings and applicable regulations, guidelines and laws.

• Provide feedback on issues related to hearings or documentation.

• Make recommendations or corrections to the record to facilitate accurate and complete record-keeping.

• Provide information and assistance to other agency personnel related to policy interpretation and required documentation to support agency decision-making.

• Render equitable decisions based on laws, rules, regulations and facts presented during the course of a hearing in order to reach a fair judgment based on the evidence presented. Ensure written decisions clearly provide all pertinent facts and details.

• Perform all other board work, as needed, to support the virtual or in-person hearing process.

ADDITIONALLY:

• The Administrative Review Officer II provides support and training to the Administrative Review Officer I in all aspects of the hearing process and decisions rendered.

• The Administrative Review Officer II assists, as needed, with Merit Rating Board point removal.

• Consult with agency counsel, the Chairperson, or the Executive Director, as appropriate, for review of agency decisions.

• Attend required training classes, as requested, to provide for continuing education relative to varied BOA needs as follows: Flaschner Judicial Institute Training Seminar for Administrative Law Judges and Hearing Officers; Advanced Driver's Education Course presented by the National Safety Council; Accident Reconstruction presented by the Massachusetts State Police.

• Participate in training as requested by the Counsel II or Chairperson, to include but not limited, methods of maximizing time management to effectuate timely writing and the prompt issuance of decisions.

• Complete other duties assigned subject to the needs of the Board of Appeal.

Preferred Knowledge, Skills, and Abilities:

• Ability to interpret, explain and apply policies, procedures, laws, rules and regulations governing department operations.

• Ability to adapt to evolving technologies and changing operational needs.

• Ability to work independently while exercising sound judgment and decision-making.

• Ability to maintain discretion and protect confidentiality of sensitive information.

• Ability to read, interpret and analyze legal documents and supporting materials.

• Ability to gather information through observation, questioning and review of records and documents.

• Ability to build rapport and maintain effective working relationships with colleagues and others.

• Ability to interact professionally with individuals experiencing physical and/or emotional stress.

• Ability to communicate tactfully and handle sensitive situations with professionalism.

• Ability to maintain calm and composed in stressful and/or emergency situations.

• Ability to organize and compile information in accordance with established procedures and formats.

• Ability to determine appropriate methods for organizing and presenting information.

• Ability to maintain accurate, organized and complete records.

• Ability to provide strong clear and precise written and verbal oral instructions.

• Ability to write and/or present ideas clearly, concisely and logically.

• Ability to deliver effective oral presentations.

• Ability to conduct structured interviews and gather relevant information.

• Ability to communicate effectively, verbally and in writing.

• Ability to analyze data, evaluate relevance, draw conclusions, and make sound decisions.

• Ability to adapt and respond effectively to changing situations and priorities.

• Ability to investigate issues, seek additional information and resolve discrepancies.

• Ability to demonstrate resilience and persistence in overcoming challenges and achieving objectives.

• Ability to solve problems, including the ability to organize information, identify root causes, and develop effective solutions.

• Ability to prepare documents, conduct research and general administrative tasks.

• Ability to work effectively and respectfully with individuals from diverse backgrounds.

• Ability to provide advice to Administrative Review Officers I based on acquired experience in all matters as they may relate to hearings.

All applicants should attach a cover letter and resume to their online submission for this position.

SALARY PLACEMENT IS DETERMINED BY YEARS OF EXPERIENCE AND EDUCATION DIRECTLY RELATED TO THE POSITION AND THE HUMAN RESOURCES DIVISION'S RECRUITING GUIDELINES. IN THE CASE OF A PROMOTIONAL OPPORTUNITY, THE SALARY PROVISIONS OF THE APPLICABLE COLLECTIVE BARGAINING AGREEMENT WILL APPLY TO (OR WILL BE UTILIZED FOR) PLACEMENT WITHIN THE SALARY RANGE.

First consideration will be given to those applicants that apply within the first 14 days.
MINIMUM ENTRANCE REQUIREMENTS: 
Applicants must have at least (A) Three years as an Administrative Review Officer I and (BA) three years of full-time, or equivalent part-time, professional experience in legal work, claims adjudication or regulatory administration, or (CB) any equivalent combination of the required experience and the substitutions below.

Substitutions:

I. Bachelor's or higher degree with a major in law may be substituted for the required experience. *

II. A Bachelor's or higher degree with a major other than law may be substituted for a maximum of two years of the required experience. *

*Education toward such a degree will be prorated on the basis of the proportion of the requirements actually completed.

Incumbents are required to have a current and valid Massachusetts Motor Vehicle

Driver's License at a Class level specific to assignment.

Comprehensive Benefits

When you embark on a career with the Commonwealth, you are offered an outstanding suite of employee benefits that add to the overall value of your compensation package. We take pride in providing a work experience that supports you, your loved ones, and your future.

Want the specifics? Explore our Employee Benefits and Rewards!

An Equal Opportunity / Affirmative Action Employer.  Females, minorities, veterans, and persons with disabilities are strongly encouraged to apply.

The Commonwealth is an Equal Opportunity Employer and does not discriminate on the basis of race, religion, color, sex, gender identity or expression, sexual orientation, age, disability, national origin, veteran status, or any other basis covered by appropriate law.  Research suggests that qualified women, Black, Indigenous, and Persons of Color (BIPOC) may self-select out of opportunities if they don't meet 100% of the job requirements.  We encourage individuals who believe they have the skills necessary to thrive to apply for this role.