Associate Medical Stop Loss Underwriter

Highmark Health; United States; Remote; Full time

Job summary

A leading company in health insurance seeks an Underwriting Analyst to analyze contract structures and claims experience. This entry-level position involves financial analysis and risk management, with support from senior staff until familiar with procedures. Candidates will collaborate across departments and adapt to dynamic conditions while maintaining compliance with ethical and legal standards.

Qualifications

• Bachelor's Degree in Mathematics, Actuarial Science, Finance, Business, Computer Science, or related quantitative field.
• 0-2 years in insurance underwriting is preferred.
• Pursuing relevant professional designations is preferred.

Responsibilities

• Manage a book of business including renewing accounts.
• Calculate rates and interpret pricing policies.
• Analyze member risk and collaborate with internal departments.

Skills

Problem-solving

Organizational skills

Negotiation skills

Strong math skills

Understanding of stakeholder interactions

Education

Bachelor's Degree in Mathematics

Bachelor's Degree in Actuarial Science

Bachelor's Degree in Finance

Bachelor's Degree in Business

Bachelor's Degree in Computer Science

Job description

Company : HM Insurance Group

Job Description :

JOB SUMMARY

This job prices 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 within the Underwriting authority, in accordance with HMIG policies, to ensure appropriate profitability and growth. The role involves identifying when to decline quotes that do not fit HMIG's strategy and risk structure. It includes analyzing risk factors for new enrollments, renewals, and amendments of group insurance contracts or self-funded plans, in line with established policies and standards. The analyst continuously improves risk management by analyzing policies, market data, and other relevant information to optimize enrollment and manage existing membership. They assess data such as financial conditions, participation rates, industry type, employee group characteristics, and past claims to determine benefit offerings and set rates. The role also involves preparing reports, providing rationale and support regarding underwriting results, rate calculations, and financial activities. This is an entry-level position, supervised by Senior Underwriters or Management until familiar with company procedures.

ESSENTIAL RESPONSIBILITIES

• Manage a book of business, including renewing accounts and writing new business profitably to meet company targets. Utilize systems and tools for data collection and tracking, with guidance from senior staff.
• Review and complete rating and analysis tasks under supervision.
• Calculate rates, interpret pricing policies, and adapt to unusual situations.
• Identify questionable claim patterns and develop recommendations.
• Apply risk management policies and adjust pricing for unique situations.
• Identify non-compliance with risk policies and recommend appropriate pricing adjustments.
• Analyze member risk and collaborate with internal departments to manage it.
• Support initiatives like fraud detection, compliance, wellness programs, and product development.
• Complete renewals and prospect quotes timely and accurately.
• Adapt to changing priorities and market requirements.
• Communicate policy recommendations clearly and support risk solutions to sales and external audiences.
• Perform other duties as assigned.

EDUCATION

Required

• Bachelor's Degree in Mathematics, Actuarial Science, Finance, Business, Computer Science, or related quantitative field.

Substitutions

• 6 years relevant, progressive experience in the field.

Experience

Minimum

• 0-2 years in insurance underwriting, preferably of self-funded or fully insured prospects.

Skills

• Understanding of internal departments and external stakeholder interactions.
• Proficiency with computer systems and applications.
• Ability to work independently on routine projects.
• Support of corporate and departmental goals.
• Ethical practices and confidentiality adherence.
• Problem-solving, organizational, and negotiation skills.
• Strong math skills for analysis.

Licensure

• None required; pursuing relevant professional designations preferred.

Travel

0-25%

Work Conditions

Office-based, with occasional travel and physical demands, including lifting up to 25 pounds.

Disclaimer

This description outlines essential duties and responsibilities and may not include all tasks performed.

Compliance

Adherence to ethical, legal, and confidentiality standards, including HIPAA and company policies, is mandatory.

Salary Range

Minimum: $22.71; Maximum: $35.18. Salary depends on qualifications, experience, and market factors.

Highmark promotes equal opportunity and accessible employment practices. For accommodations, contact [e-mail].