Underwriter III

Job Type

Full-time

Description

The Underwriting Department applies the knowledge of Allied's products, plan documents, underwriting manuals and computer systems. This includes company procedures and philosophies, along with using sound judgment, to assess the risk and establish pricing to insure the profitability of new and renewal business. The underwriter will work in a team atmosphere utilizing not only their own expertise but also the expertise of their peer group. An important component of this position is to provide the services mentioned above in a positive, professional, thorough, and courteous manner, enabling Allied to be recognized as a service-driven organization.

As the voice of Allied underwriting, communication with the Account Executives and our customers is a critical component of this position. Utilizing medical expertise in the overall risk evaluation and rate recommendation is essential for this position.

1. Must be proficient in all functions in Levels 1, 2 & 3 in accordance with department quality and quantity production standards.
2. Underwrite New Business according to parameter guidelines and determine eligibility of a group for health insurance based upon a review of all eligibility information that has been obtained.
3. Review Medical Load Report prepared by level 2, and evaluate appropriate medical risk.
4. Review Participation Worksheet and Group Eligibility prepared by level 2.
5. Review Current Carrier Bills and Renewal Rates and compare to census presented and Allied generated rates.
6. Conduct employer phone call and as needed contact individual applicants for additional health information and or clarification.
7. Send out final new business rate and run any alternate quotes approved by Level 4.
8. Create Self-Funded Accounts in AI.
9. Review Allied and MGU Pre-Screens completed by Level 2 and make appropriate documentation to be reviewed by Level 4.
10. Review Health Renewals & load into spreadsheet.
11. Review and create synopsis of claim referrals to determine medical eligibility of an insured to be finalized by level 4.
12. Review and create synopsis of IDC complaints to be finalized by level 4.
13. Process appropriate contact management & UAS mailbox activities.
14. Determine appropriate rate for additions on Ancillary Products.
15. Review recommendations from Level II on Ancillary late enrollee and Short Term medical rewrite applications.
16. Review monthly manual dental renewals, populate spreadsheet with rating recommendations to be approved by underwriting management.
17. Quality review accuracy of Dental Monthly renewals.
18. Meet established department production standards for quality and quantity.

1. High School graduate or equivalent.
2. One to two years related work experience or equivalent college education.
3. Certification in Medical Terminology I and II.
4. Ability to comprehend and interpret information directly from product brochures, certificates and insurance contracts.
5. Ability to speak, read, comprehend and follow written and verbal English instructions.
6. Ability to communicate effectively verbally and in writing.
7. Basic mathematics skills.
8. Demonstrated decision-making skills and the ability to work with minimal supervision.
9. Excellent planning and organizational skills.
10. Ability to meet company attendance requirements.
11. Ability to sit or stand at workstation for 7 &fac12; hours per day.
12. Ability to withstand the stress of meeting deadlines and telephone calls from irate agents or other individuals.
13. Ability to meet departmental training, quality and production standards.
14. Must meet all requirements listed above under Level 1 & 2.
15. Minimum 4 years of office experience or equivalent college education.
16. Knowledge and understanding of medical terminology.
17. Very strong knowledge and understanding of medical terminology.
18. Minimum 3 years experience in the insurance industry, including 1-2 years experience in group and individual medical underwriting preferred, or equivalent medical background.