Skyward Specialty Insurance

Consultant

• Ensure effective risk management through reviews and assessment of new business and renewal large claims/disclosures
• Assist underwriters in evaluating clinical and claims data and provide reporting of analysis findings, observations, and recommendations
• Explain complex clinical conditions to the team
• Develop and maintain client, TPA, and vendor relationships
• Consult with clients and TPAs on case management, alternative levels of care, program development, quality improvement, claims issues, and educational needs
• Work with claim teams to develop cost mitigation strategies and achieve effective clinical and financial outcomes
• Assist with medical necessity determinations and claim audits
• Perform transplant and complex/catastrophic care reviews, including treatment-plan medical necessity and experimental-treatment reviews
• Consult on high-cost claims and implement clinical risk-management strategies
• Determine the need for extra-contractual agreements or specialty resources and act as liaison until claim completion
• Serve as a risk-management resource for claims and underwriting related to Accident & Health claims
• Establish and adjust reserve recommendations and review them monthly
• Communicate risk factors, resolve complex inquiries, and develop continuous-improvement recommendations

Clinical Consultant – Accident & Health

Accounts Receivable

• Accurately process and apply premium payments, obtain backup worksheets, correct backup documentation, and send variance correspondence
• Handle disbursement transactions for returned premiums
• Prepare and analyze variance reports and reconcile incorrectly applied premiums
• Send variance communications for short or overpayments to third-party administrators
• Maintain detailed journal notes of corrections
• Process premium backouts and reapplications due to Policy Administration system changes
• Initiate and process ACH setups for new vendors and accounts
• Respond to Skyward team and third-party administrator queries
• Manage high-volume daily working emails and maintain an organized premium payment email folder
• Collect and prepare audit backup documentation and assist with auditor requests and compliance checks
• Generate and distribute annual 5500 – Schedule A reports
• Create and manage daily/monthly cash reconciliation folders and organize TPA backup worksheets
• Identify and suggest process optimizations for AR functions
• Support month-end and year-end closing activities
• Maintain comprehensive AR records in accordance with company policy and insurance regulations
• Collaborate with Finance, Underwriting, Claims, and IT teams to resolve billing issues
• Track key AR metrics and report on status, trends, and outstanding items
• Provide training support to team members
• Assist with special projects and ad hoc assignments

Accounts Receivable Analyst – Accident & Health

Actuary

• Support the development, testing, maintenance, and documentation of pricing tools used to price business accurately and effectively
• Assist with portfolio analyses, including reviews of composition, premium, retention, loss, and profitability metrics across products and lines of business
• Compile rate, retention, and other performance metrics; summarize results and support communication of data-driven insights to business partners and management
• Assist in developing and maintaining rating manuals, rate filings, and supporting actuarial documentation
• Use actuarial tools, data, and modeling software to support pricing, valuation, and risk-management analyses
• Participate in discussions with underwriting and claims personnel regarding profitability, business performance, and strategic direction
• Support development of business recommendations and analyses of pricing and portfolio strategies
• Research industry trends and assess potential implications for pricing processes and portfolio performance
• Develop familiarity with company operations, insurance products, systems, and actuarial methodologies
• Manage assigned work accurately and on time while maintaining sound judgment, attention to detail, and appropriate documentation

Actuarial Analyst, P&C Pricing

Analyst

• Serve as the primary subject matter expert for all leave of absence programs, including FMLA, ADA accommodations, short- and long-term disability, state-paid family and medical leave programs, and unpaid leaves
• Manage the full leave lifecycle, including intake, eligibility review, documentation, payroll coordination, return-to-work processes, accommodations, and case resolution
• Monitor federal, state, and local leave regulations and recommend policy, process, and communication updates
• Partner with managers, HR, Payroll, Legal, and third-party administrators to address complex leave situations and escalations
• Maintain leave reporting, audits, and employee communications
• Administer health and welfare, retirement, and voluntary benefit programs
• Manage benefit enrollments, vendor file feeds, billing, invoicing, audits, and payroll-related reconciliations
• Support benefit plan operations, employee inquiries, and vendor issue resolution
• Assist with open enrollment planning, employee education, and ongoing benefits communications
• Develop and maintain reports related to benefits, leave, compliance, and workforce trends
• Analyze data to identify discrepancies and opportunities for process improvement
• Support compliance requirements, audits, plan documentation, and regulatory reporting
• Leverage technology, reporting tools, and approved AI-enabled solutions to improve efficiency and enhance service delivery
• Partner with Human Resources, Payroll, Finance, Legal, and external vendors to deliver a compliant, efficient, and employee-focused benefits experience

Clinical Consultant – Accident & Health

Accounts Receivable Analyst – Accident & Health

Actuarial Analyst, P&C Pricing

Senior Benefits Analyst