Associate Medical Stop Loss Underwriter

Highmark Health•Washington, DC

6d•$23 - $36•Onsite

About The Position

JOB SUMMARY This job pricies quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent develops and uses discretion of Underwriting authority, within the policies of HMIG, and ensure appropriate levels of profitability and growth over time. Identifying when to decline quotes that do not fit into the overall HMIG strategy and risk structure. Analyzes risk factors for new enrollment, annual renewals, and amendments of group insurance contracts or of self-funded plans in conformance with established underwriting policies, practices, and standards. Analyzes associated policies, guidelines, market data to continuously improve risk management and gain appropriate enrollment or manage existing membership. Analyzes data such as financial conditions of the organization, participation percentage, type of industry, characteristics of employee groups, or past claim experience to determine what benefits can be offered and to set the rates. Prepares a variety of reports and provides rationale and support to other areas within the organization, clients, and possibly producers regarding one or more of the following: underwriting results, rate computations and financial activity. Provides expense estimates and accurate analysis of financial exhibits. This is an entry level position, with oversight by Senior Underwriters and/or Management until the individual is acclimated to the Company procedures, policies and protocols.

Requirements

Bachelor's Degree - Mathematics, Actuarial Science, Finance, Business, Computer Science or other quantitative analysis discipline
0 - 2 years of experience in Insurance, Underwriting of Self-Funded and/or fully insured prospects preferred
Developing understanding and knowledge of various internal departments and external stakeholder interacts
Ability to use applicable computer systems, electronic tools and applications
Ability to work independently and assume responsibility for routine projects
Demonstrate an understanding and support of corporate and departmental goals and initiatives
Demonstrate ethical business practices with adherence to all privacy and confidentiality policies and regulations
Good problem-solving, organizational, and negotiation skills required
Excellent math aptitude required to complete analysis

Nice To Haves

None
Actively pursuing a professional designation related to the healthcare industry and be willing to complete one course within twelve months in either Life Office Management Association (LOMA) Certified Employee Benefit Specialist (CEBS), or America's Health Insurance Plans (AHIP)

Responsibilities

Responsible for a book of business of renewing accounts and writing new business at profitable levels to help HMIG achieve overall business targets/ or assigned volume of new applications or RFP’s.
Utilizes various systems and tools to obtain necessary data and accurately complete and track assigned work.
Receives guidance, technical oversight from other staff members.
Review and complete Rating and Analysis work with guidance and technical oversight from other staff.
Calculate rates, employs different financial arrangements, interprets pricing policy and adapts to unusual situations.
Identify questionable claim patterns of renewal clients and issues with competitor’s claims experience for prospect clients and develops recommendations to account for these situations.
Apply corporate risk management policies and adjust for unusual situations that may not have been considered in the standard pricing formula.
Identify when clients do not comply with corporate risk management policies, disclosure rules, or conditions/criteria for enrollment.
Recommend appropriate adaptation of pricing within the appropriate policy/guideline to accommodate each client specific or individual situation.
Analyze member risk and engages internal departments to manage this risk.
Support other internal initiatives which may include but not limited to fraud detection, corporate compliance, wellness/disease management, and product development efforts.
Complete renewals, prospect quotes, in accordance with production and timeliness standards.
Adapt to changing priorities as quotes come in from different markets and adapt to new priorities and requirements.
Communicate recommendations of policy adaptation to accommodate client-specific situations supported by a clear rationale or management principles.
Influence sales and external audiences toward appropriate risk solutions.
Influence sales team towards the appropriate pricing and structure of each quote.
Other duties as assigned or requested.