Medical Risk Specialist
3 days ago
Vensure Employer Solutions offers a competitive compensation package including an estimated annual salary of $65,000-$85,000, depending on experience and qualifications.
About the CompanyWe are a proud provider of comprehensive portfolio solutions, including HR/HCM technology, managed services, and global business process outsourcing (BPO). Our company serves over 95,000 businesses and processes over $135B in annual payroll.
About the RoleWe are seeking a skilled Medical Risk Specialist to join our team. As a Medical Risk Specialist, you will be responsible for assessing medical risk for our sponsored medical plans. You will work within specific limits of authority on assignments requiring significant technical complexity and coordination.
You will utilize underwriting policies and guidelines, rating rules, and carrier regulations to appropriately price medical risk. Your role will also involve working with sales and support teams to ensure all required collateral is received, and explaining discrepancies with submissions.
In addition, you will calculate rates for complex group cases based on thorough analysis of the group's experience, industry, location, size, and demographic nature using underwriting methodologies.
Key Responsibilities- Collect and review customer-specific information such as existing group medical plans and rates, employee census, carrier history, and previous claim experience to ensure submission completion and accuracy.
- Work with sales and support teams to ensure all required collateral is received and explain discrepancies with submissions.
- Calculate rates for complex group cases based on thorough analysis of the group's experience, industry, location, size, and demographic nature using underwriting methodologies.
- Develop judgment to assess new business for master medical plans as needed while working with senior underwriters or management to ensure a profitable book of business.
- Review and complete all sales requests and inquiries within company-established standards and policy guidelines.
- Update all underwriting systems as appropriate.
- Provide underwriting knowledge sharing and education to peers and/or members of the sales team.
- A High School Diploma is required, an Associate's degree is preferred or comparable experience.
- Insurance carrier underwriting experience is preferred 2+ years.
- PEO underwriting experience is preferred 2+ years.
- Familiarity with office environments.
- Proficiency in Microsoft Word, PowerPoint, and Excel.
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