Rating Specialist

Job Summary: Manage outlook mailbox for quote requests, high level screening for underwriting risk requirements and claim data, and provide manual rates to the underwriters.

Supervisory Responsibilities: None

Duties/Responsibilities:

· Manage shared email box throughout the day for electronically submitted Request for Proposals (RFP’s)

· Save RFP attachments on shared drive, organized by client

· Enter case specific information into the underwriting data base

· Provide high level prescreening RFP information for completeness and acceptable risk characteristics

• 1. Need recent two years of Medical and RX paid claims with corresponding enrollment and large claims
• 2. Review for eligible Industry and participation requirements (per carrier)
• 3. Review for State minimums guidelines by Carriers
• 4. Review for complete census and manipulate into accurate format for input in underwriting system.

· Correspond with various clients, brokers and TPAs for missing or discrepant RFP information Send email requests and follow-up correspondence for missing RFP information

· Review Schedule of benefits for network and type of plan to be used (PPO/EPO/POS)

· Download census data, RFP data and benefit information into underwriting system

· Run manual versus current rate calculation for self-funded groups

· Verify census vs enrollment information on latest Aggregate Report provided and resolve any discrepancies

· Submit case to UW

Required skills/abilities:

· Ability to work well in a fact paced team environment

· Proficient in excel

· Data entry skills with high level accuracy

· Ability to decipher numerous types of claim reports

· Ability to determine specific diagnosis codes of concern

· Ability to understand plan documents and schedule of benefits

· Ability to identify self-funded versus fully insured rates

· Ability to think outside the box

· Organized with attention to detail

· Ability to correspond professionally with clients

· Reliable

· Flexible and ability to embrace change

Education/Experience:

· Stop loss Insurance Background required, at least 3 years

· Bachelor’s degree preferred but not required

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Flexible schedule
• Health insurance
• Paid time off
• Vision insurance
• Work from home

Shift:

• 8 hour shift

Weekly day range:

• Monday to Friday

Work setting:

• Hybrid work
• Office

Education:

• Bachelor's (Preferred)

Experience:

• Stop Loss Insurance: 3 years (Preferred)

Work Location: Hybrid remote in South Windsor, CT 06074