What are the responsibilities and job description for the Underwriter position at Captive Resources and Careers?
The Underwriter is responsible for evaluating and underwriting stop-loss insurance. The role involves analyzing medical risk, pricing policies, and making recommendations based on a thorough understanding of both medical costs and insurance principles.
EDUCATION AND EXPERIENCE: A bachelor’s degree in business, finance, insurance, mathematics, or a related field. 2 -5 years of experience in insurance underwriting, preferably in the health insurance or medical stop-loss field. Experience with medical claims analysis, pricing, and risk management is essential.
SKILLS/COMPETENCIES REQUIREMENTS:
- Stay updated on industry trends, regulatory changes, and best practices in medical stop-loss underwriting.
- Risk management principles and stop-loss insurance products.
- Medical terminology, healthcare costs, and trends in medical claims.
- Regulatory and compliance issues in insurance underwriting.
- Strong analytical and problem-solving abilities.
- Proficiency in underwriting software (Connexure ESL Office).
- Excellent written and verbal communication skills for client interaction and report creation.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Evaluate submissions for medical stop-loss insurance of assigned captive program(s), assessing the risk posed by each potential policyholder.
- Analyze medical claims data and historical health costs to determine appropriate stop-loss coverage levels, including individual and aggregate limits.
- Review group health plans, claims experience, and member demographics to assess the potential for high-cost claims.
- Develop premium pricing for stop-loss insurance policies based on risk analysis and underwriting guidelines within delegate authority.
- Establish appropriate retention levels, deductible amounts, and policy terms based on the group’s needs and risk factors.
- Analyze claims data to assess trends, predict future claims, and identify risk patterns.
- Use various tools, including statistical analysis and software systems, to track claims history and predict future healthcare costs.
- Collaborate with clinical risk management team to assess potential for ongoing claims liability.
- Engage with internal and external stakeholders to explain policy terms, underwriting decisions, and negotiate terms when necessary.
- Support the sales team by providing underwriting insights and assisting with the proposal process for new business.
- Ensure all underwriting activities comply with regulatory requirements, industry standards, and company guidelines.
- Maintain accurate records of underwriting decisions, policies, claims history, and communication with clients.
TRAVEL: Occasional travel may be required for meetings, conferences, or client visits. This includes compliance with all of the requirements of the localities and destinations, as well as transportation carrier requirements.
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Applicants have rights under Federal Employment Laws: Family and Medical Leave Act (FMLA) Poster; Equal Employment Opportunity (EEO) Poster; and Employee Polygraph Protection Act (EPPA) Poster