Medical Risk Evaluator
hace 2 semanas
Job Summary
The Health Insurance Medical Underwriter will be responsible for assessing and evaluating medical risks for individual health insurance applications. This includes determining whether to accept or decline applicants and setting appropriate terms based on the risks involved.
Key Responsibilities
- Evaluate health insurance applications using company guidelines, standards, and procedures to assess the medical risks presented.
- Analyze the pertinent medical history of new and existing applicants to assess the degree of risk and decide on policy issuance.
- Recommend coverage options within the company's parameters, claims costs, and plan availability.
- Provide expert medical opinions when necessary to address cases of fraud or misrepresentation.
- Work effectively with field representatives, medical personnel, and other teams to obtain additional information as needed for proper risk evaluation.
- Handle complex underwriting tasks with minimal supervision, analyze results, and make informed recommendations based on findings.
- Ensure that all client and medical information remains confidential and adheres to privacy standards.
- Stay updated on new medical developments to improve underwriting effectiveness.
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