Address
Form of workFountain Health
Senior Medical Underwriter
Summary: The Senior Underwriter is responsible for underwriting new and renewal medical stop loss accounts at a profitable level and managing the relationships with internal team and vendors to ensure the alignment with overall company stop loss goals.
Essential Duties and Responsibilities:
Evaluates risk on current business and new business prospects, makes decisions to quote or decline to quote, and develops premium rates in accordance with underwriting guidelines and authority limits.
- Develops and communicates new business or renewal rate recommendations and decisions in accordance with level of underwriting authority.
- Evaluate group claims experience, high claimant information, disclosure statements and/or individual medical applications for risk.
- Composes, prepares, and generates correspondence, proposals, and other reports as needed or required.
- Independently provides detailed explanations to internal team regarding conditions and requirements of quotes, rating decisions and other information to support sale of new and renewal business.
- Negotiates rates, terms, and conditions for new and existing business.
- Manages new business and renewal book to balance profitability and growth.
- Processes sold accounts and confirmed renewals following established procedures.
- Develops and maintains relationships with sales representatives to support Company’s production goals and persistency.
- Supports Fountain Health Insurance growth initiatives related to self-funded plans reference-based pricing, captive.
- Reviews plan design and calculates rates for requested or recommended plan changes.
- Provides competitive feedback on rates, products, pricing, and marketing strategies.
- Makes presentations to peers, producers, and leadership, as necessary.
- Relies on departmental tools, experience, and judgment during underwriting process to set pricing, review risk, negotiate, and accomplish goals.
- Assists associate underwriters with training and peer review.
- Respond to email and phone inquiries from Producers and Sales Directors with regard to the quoted rates.
- Support Actuarial team on ad hoc requests and various other projects as requested.
- Create electronic records of all relevant quote data.
- Maintain various databases, reports, projection models, and other tools used to evaluate new business opportunities and existing business performance a periodic basis.
Qualifications:
Education and/or Experience:
- Bachelor’s Degree and 5 years of related experience or equivalent combination of education and experience.
- 5+ years of experience underwriting medical stop loss required.
- Preferred experience underwriting self-funded, reference based pricing, captives and large group programs.
OR
- Professional certifications (HIAA, CEBS, FMLI, etc.) beneficial
- Bachelor’s degree in Mathematics, Actuarial Science, or other quantitative analysis discipline required.
- Minimum of five years of group health underwriting or actuarial experience required.
- Self-funded and medical stop-loss underwriting experience preferred.
Knowledge, Skills and Abilities:
- Excellent mathematical, analytical, and critical-thinking skills.
- Understanding of reference based pricing, and ability to communicate features
- Proficient in Microsoft Office Suite (Outlook, Word, Excel)
- Excellent written and verbal communication and presentation skills.
- Broad working knowledge of laws and regulations impacting area of responsibility.
- Ability to carry out assignments within parameters of instructions given prescribed routines and standard accepted underwriting practices.
- Ability to prioritize and balance a dynamic workload.
- Proficient written and verbal communication skills required.
- Advanced computer skills (Microsoft Word, Excel, Access, and PowerPoint) required.
- Strong organization skills preferred.
- Ability to manage multiple projects / tasks required.
- Attention to details (task listing and follow-up) required.
- Ability to articulate thoughts in a clear and concise manner preferred.
- Must have knowledge of the specific information required in order to prepare rate quotes.
- Must be efficient and deliver quotes within the standard turnaround time.
- Must provide courteous and professional customer service.
- Ability to do repetitive, highly detailed work for significant periods-of-time without losing quality of work required.
- Problem solving skills required.
