What are the responsibilities and job description for the Medical Underwriter position at BEST DOCTORS INSURANCE SERVICES LLC?
JOB PURPOSE:
Provide medical underwriting and risk assessment on individual health insurance applications. Decide on acceptance or decline of applicant, as well as what the terms of acceptance are as per the risks presented. Communicate with agents/clients on decisions made, support marketing and sales area of current and prospective agencies.
ESSENTIAL JOB DUTIES AND RESPONSIBILITIES:
- Medically underwrite the risks presented by new and/or existing individual policies utilizing the health underwriting guidelines, procedures and standards developed by the company to evaluate different medical conditions and the risk they represent.
- Review pertinent medical history of new and/or existing individual applicants as it relates to degree of risk involved and determine acceptance of applications under underwriting guidelines.
- Ability to provide insurability options within the set parameters of the companies underwriting guidelines, claims costs and plan options.
- Ability to provide explanations and interpretations for internal departments as well as external agents/members; answer agent/member questions regarding our products and services such as plans, information on exclusions, and, as needed, provide medical expertise opinions in order to evaluate claims and help to identify cases of potential fraud and/or misrepresentations.
- Effectively communicate with field representatives, medical personnel, and others to obtain any additional information required to properly evaluate risks.
- Perform daily tasks including complex duties independently with minimal supervision. Demonstrated ability to analyze results and make recommendations based on this analysis.
- Ensure to enforce confidentiality guidelines in referent to agent/members general and medical information.
- Continued education of new medical information as it applies to the evaluation of risks.
DESIRED MINIMUM QUALIFICATIONS: Education and Experience:
- Foreign Medical Degree
- Minimum of 2 years experience as a medical underwriter for a health and/or life insurance carrier
- Proficiency in medical terminology
- Experience in a customer service oriented environment
- Experiences working with the Latin American market a plus
Other Skills:
- Good oral and written skills in both English and Spanish
- Interpersonal effectiveness
- Good judgment and problem-solving skills
- Detail Oriented
- Effective planning, organization and time managements skills
- Flexible, proactive, and self-motivated Proficiency with Microsoft Office Team player