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Medical Risk Assessment Specialist
2 months ago
About Vensure Employer Solutions
Vensure Employer Solutions stands as the largest privately held entity in the HR technology and service domain, offering a wide-ranging suite of solutions, including HR/HCM technology, managed services, and global business process outsourcing (BPO).
The organization and its partners collectively cater to over 95,000 businesses and manage an impressive $135 billion in annual payroll.
Position Overview
The Health Underwriter plays a crucial role in evaluating medical risk for a PEO-sponsored medical plan. This position operates within defined limits of authority on tasks that require substantial technical complexity and coordination. The underwriter applies underwriting policies, guidelines, rating rules, and carrier regulations to accurately price medical risk.
Key Responsibilities
- Collect and analyze customer-specific data, including existing group medical plans, rates, employee census, carrier history, and prior claims experience to ensure submission accuracy and completeness.
- Collaborate with Sales and support teams to gather all necessary documentation for quoting. Clearly communicate any missing items or discrepancies.
- Calculate rates for intricate group cases based on a thorough assessment of the group's experience, industry, location, size, and demographic characteristics using established underwriting methodologies.
- Develop judgment to evaluate new business for master medical plans in collaboration with senior underwriters or management, ensuring a profitable portfolio.
- Review and respond to all sales requests and inquiries in accordance with company standards and policy guidelines.
- Update all underwriting systems as necessary.
- Share underwriting knowledge and provide education to peers and members of the sales team.
Qualifications
- High School Diploma required; Associate's degree preferred or equivalent experience.
- Preferred experience includes 2+ years in insurance carrier underwriting and 2+ years in PEO underwriting.
- Proficiency in Microsoft Word, PowerPoint, and Excel is essential.
- Familiarity with an office environment is beneficial.
Skills and Abilities
- Proficient in using a computer, keyboard, and screens to access necessary information.
- Ability to read and interpret documents such as safety rules, operating instructions, and procedure manuals.
- Capable of writing routine reports and correspondence, and effectively communicating with employees, managers, and external stakeholders.
- Strong mathematical skills, including the ability to perform calculations involving whole numbers, fractions, and decimals.
- Ability to apply common sense to carry out instructions in various formats.
- Excellent time management, resource management, and planning skills.
- Detail-oriented with the ability to manage multiple tasks in a fast-paced environment.
The ideal candidate will possess a professional demeanor, a strong work ethic, and a commitment to quality.
