Health Insurance Underwriting Specialist
hace 4 meses
Medellín
Description:
We are seeking a qualified individual for the role of Medical Underwriter to join our team. The primary responsibility of this position is to provide medical underwriting and risk assessment for individual health insurance applications. The successful candidate will be responsible for evaluating different medical conditions and determining the acceptance or decline of applicants, as well as defining the terms of acceptance based on the presented risks. Effective verbal and written communication with agents and clients on medical decisions is crucial for success in this role
Responsibilities:
- Medically underwrite risks presented by new and existing individual policies, adhering to health underwriting guidelines, procedures, and company standards.
- Review pertinent medical history of applicants to assess the degree of risk and make acceptance decisions under established guidelines.
- Provide insurability options within company parameters, considering underwriting guidelines, claims costs, and plan options.
- Explain and interpret medical decisions to internal departments and external agents/members, addressing inquiries about plans, exclusions, and providing medical expertise opinions for claims evaluation.
- Communicate effectively with field representatives, medical personnel, and others to obtain additional information necessary for proper risk evaluation.
- Independently perform daily tasks, including complex duties, with minimal supervision. Analyze results and make recommendations based on thorough analysis.
- Enforce confidentiality guidelines regarding agent/member general and medical information.
- Stay updated on new medical information relevant to risk evaluation.
Requirements:
- Foreign Medical Degree.
- Minimum of 2 years of experience as a medical underwriter for a health and/or life insurance carrier.
- Proficiency in medical expertise.
- Experience in a customer service-oriented environment.
- Experience working with the Latin American market.
Other Skills:
- Good oral and written skills in Portuguese, Spanish, and English.
- Interpersonal effectiveness.
- Strong medical judgment and problem-solving skills.
- Detail-oriented.
- Effective planning, organization, and time management skills.
- Flexibility, proactivity, and self-motivation.
- Proficiency with Microsoft Office.
- Team player.
At ttg, “We believe in making a difference One Person at a Time,” ttg OPT
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