Overview:
The Medical Underwriter plays a critical role in the insurance industry, evaluating medical information and determining the risk associated with insuring applicants. This position requires a strong understanding of medical terminology, insurance policies, and risk assessment to make informed decisions about coverage and premiums.
Key Responsibilities:
1. Risk Assessment:
- Review and analyze medical records, lab results, and other relevant health information to assess the risk of insuring applicants.
- Evaluate the overall health status of applicants to determine eligibility for coverage.
2. Policy Evaluation:
- Interpret insurance policies and guidelines to ensure compliance with underwriting standards.
- Make recommendations for policy adjustments based on individual health risks.
3. Decision Making:
- Determine appropriate coverage levels and premiums based on risk analysis.
- Communicate decisions clearly to agents, brokers, and applicants as needed.
4. Collaboration:
- Work closely with insurance agents, brokers, and healthcare providers to gather necessary information for underwriting decisions.
- Collaborate with other underwriters and departments to ensure consistency in underwriting practices.
5. Documentation:
- Maintain accurate records of underwriting decisions, including rationale for approvals or denials.
- Prepare detailed reports summarizing findings and recommendations.
6. Continuous Learning:
- Stay updated on medical advancements, changes in healthcare regulations, and industry trends that may impact underwriting practices.
- Participate in ongoing training and professional development opportunities.
7. Customer Service:
- Provide exceptional service to clients by addressing inquiries and concerns regarding underwriting decisions.
- Assist clients in understanding policy options and the implications of their health status on coverage.
- Bachelor’s degree in a related field (e.g., healthcare, finance, business) or equivalent experience.
- Previous experience in medical underwriting or a related field is preferred (3 years).
- Knowledge of medical terminology and health conditions.
Skills:
- Strong analytical skills with attention to detail.
- Excellent verbal and written communication skills.
- Proficiency in using underwriting software and databases.
- Ability to work independently and make sound judgments under pressure.