A Medical Underwriter works for the insurance agencies and insurance carriers and works to minimize the potential financial loss relating to providing health or life insurance policies. A well-written Medical Underwriter Resume mentions the following core duties and tasks – reviewing application files for health and life insurance policies; determining eligibility coverage, premium rates, and exclusion policies for consumers and businesses; helping to determine the amount of financial risk that occur as a result of insuring individual or group of people, making decisions on how to and how not to underwrite an insurance policy; and evaluating the files of potential insurance policyholders.
Employers want their Medical Underwriters to have a degree in areas such as finance or its equivalent. Prior work experience in the industry is also expected. However, new underwriters are provided on-the-job training to start their career in this line. Besides, the potential candidates are expected to possess knowledge of newly approved government regulations and tax laws.
Summary : Responsible for Analyzing insured demographics, plan design, and claim experience, Collaborating with our clinical and risk management teams to deliver sophisticated cost mitigation and care management strategies to our brokers and insureds.
Skills : Microsoft Office Suite, Management, SAP, Training & Development, Training.
Description :
Serviced boutique life insurance, long-term care, fixed annuity and settlement brokerage firm designed to assist high-end producers maximize value provided to clients.
Communicated with life insurance carriers and brokers about complex client medical files.
Critically reviewed and summarized medical files.
Clarified medical diagnoses, diagnostic tests (EKG's, Stress Tests, CT scans, pathology reports), morbidity/mortality risks and trends.
Provided suggestions to improve client's mortality risk.
Maintained knowledge base of industry underwriting practices.
Maintained RN licensure and expertise in medical concepts with continuing education.
Experience
7-10 Years
Level
Management
Education
B.S. In Nursing
Medical Underwriter Resume
Headline : Obtain a Medical Underwriter position that will utilize my skills and experience in the managed healthcare industry and the retail sales industry to achieve effective delivery of service, improve accountability, an enhanced competitive position in retail sales and the health care services market.
Skills : Medical Skills, Communication Skills, Management Skills.
Description :
Reviewed applications for individual health insurance policies.
Determined the medical risk of any given diagnosis using proprietary medical guidelines and any pertinent medical source needed to complete the medical risk evaluation.
Reviewed applicants from 50 states.
Required knowledge of the medical insurance underwriting guidelines and individual state mandates that can change on a daily basis.
Communicated with more than 50 healthcare brokers nationwide to update status of the applications and obtain needed information from applicants to offer the best and most affordable health insurance policies.
Collaborated with team of staff physicians and nurses to assess individual medical risks by presenting cases that exceeded proprietary medical guidelines and/or state mandates to the medical panel via web meetings held on a daily basis.
Trained and mentored new and fellow underwriters on changes in state mandates and any software changes.
Experience
5-7 Years
Level
Executive
Education
Bachelor's In Human Services
Medical Underwriter Resume
Summary : Professional and detail oriented individual with more than 27 years of work experience. Knowledgeable in customer service(internal and external), telephone skills, written communication skills, ms office(word, excel, powerpoint, outlook) data entry, medical underwriting, medical terminology, claims audit and claims processing.
Assessed the risk of applicants by reviewing health insurance applications.
Conducted telephone interviews in a professional and HIPPA compliant manner for the purpose of clarifying health history.
Interpreted and documented lab and exam results.
Interpreted and documented attending physician statements.
Interpreted and documented prior claims experience along with prior underwriting actions.
Reviewed and responded to verbal and written appeals on underwriting decisions.
Worked closely with agents, customer service representatives and insureds via phone, email and written mail to issue health insurance policies.
Experience
10+ Years
Level
Senior
Education
High School Diploma
Medical Underwriter Resume
Objective : Responsible for Contributing in the design of products that leverage deep knowledge of risk contracting models, provider performance data, and actuarial modeling to design and price MSL products and policies.
Skills : Microsoft Office, Type 55 WPM, ICD 9 Codes, Code It Right, Epic, Claims, Data Entry, Great Verbal And Writing, Honest, Personable And Well Spoken.
Description :
Reviewed medical records, labs, inspect reports and determine eligibility, MIB coding, order required labs, and records Broad experience communicating with physicians, attorneys, and customers.
Analyzed business processes and systems.
Identified processes for improvement.
Responsible for designing and implementing class curriculum and evaluating the knowledge of participants in compliance with state guidelines.
Responsible for the development of our underwriting computer program.
Tested software and provided workflow documentation.
Assisted in defining program information.
Experience
2-5 Years
Level
Executive
Education
GED
Medical Underwriter Resume
Objective : Responsible for Contributing to the design of products that leverage deep knowledge of risk contracting models, provider performance data, and actuarial modeling to design and price MSL products and policies.
Independently created a training manual for supervisors and new employees.
Challenged assignments and the opportunity to contribute to the results of a team.
Collaborated learning and group assignments with program members to help gain broader organizational understanding.
Technical trained to deepen your skill level within your chosen discipline; and an understanding of our broader industry.
Peer mentored support to help members navigate through professional situations in their early development.
Analyzed insured demographics, plan design, and claim experience.
Collaborated with our clinical and risk management teams to deliver sophisticated cost mitigation and care management strategies to our brokers and insureds.
Experience
2-5 Years
Level
Executive
Education
Associate's In Creditable
Medical Underwriter Resume
Objective : To obtain a challenging Medical Underwriter position that will best utilize my leadership skills and give me the ability to advance within an enthusiastic and innovative professional environment. Looking to improve my position in the workforce, expand my knowledge and skills but, will enjoy discussing other available positions for which I am qualified.
Analyzed the data in the insurance application forms and determine the creditworthiness of the applicant in complex and intriguing cases.
Consulted and worked with the state insurance laws and regulations and/or legislation.
Referred to our head office in the underwriting department for any clarifications or changes in the insurance underwriting coinciding with company policy.
Facilitated the training of the junior underwriters about the insurance underwriting policies and strategies to improve product quality on our team.
Designed and shaped the underwriting manuals for the other junior team members.
Evaluated the financial position of the company and attend all audit meetings.
Experience
2-5 Years
Level
Junior
Education
GED
Medical Underwriter Resume
Headline : Motivated and highly productive Medical Underwriter professional with a research background. Detail-oriented with strong skills in multi-tasking and efficient management of day-to-day office operations. Adept at building and maintaining effective working relationships with co-workers and clients through outstanding interpersonal skills.
Skills : Medical Diagnosis And Drug, Realestate Deeds, And Plat Maps. Data Entry, Analysis, And Summation.
Description :
Assessed medical risk of commercial groups utilizing general directives and priced mostly standardized plans with rider variation.
Utilized Excel, Access, and Word to format technical information into sales person friendly format.
Write and analyze standard operation procedures, propose modifications, implement changes.
Create and lead training.
Planned, depict, and formated the training programs for the insurance agents while introducing the new plans or modifications made in an existing and presiding policy.
Planned, and formated the training programs for the insurance agents while introducing the new plans or modifications made in an existing and presiding policy.
Negotiated policy pricing, structure, terms, and conditions.
Experience
5-7 Years
Level
Junior
Education
BA In Psychology
Medical Underwriter Resume
Objective : Medical Underwriter with 3 years of experience in Communicating properly and timely with all producers regarding submissions and decisions for new or renewal business, Approving and disapproving endorsement requests according to internal and Company guidelines.
Skills : Customer Service, Problem Solving, Data Entry, Medical Underwriter.
Description :
Reviewed, analyzed, and evaluated medical records for Structured Settlement claimants to forecast and project changes in life expectancy based upon medical condition and/or accidents.
Worked with Structured Settlement Annuity staff to develop best practices for medical underwriting.
Maintained and researched medical and pharmaceutical developments relative to changes in life expectancy for various medical conditions.
Performed research on deviations in projected life expectancy based upon company and industry mortality experience and data.
Worked remotely, and independently, as well as maintain service standards with a constant high volume of files for review.
Read and interpreted medical records for diseases, treatments, and outcomes regarding a patient's life expectancy.
Managed the queries or lawsuits filed against any insurance claims.
Experience
2-5 Years
Level
Executive
Education
MSN
Medical Underwriter Resume
Headline : Responsible for Monitoring production hit ratios, renewal retention ratios spread of risk, and other production and quality measures to minimize risk and predict future success.
Skills : Customer Service, Communication, Marketing, Recruiting, Training, Microsoft Office.
Description :
Worked closely with marketing and sales team to provide acceptance and or denial of employer's application for group health, life, dental, vision, and/or weekly indemnity insurance.
Analyzed, assessed, rated, the potential risk factor of a company group's eligibility, medical conditions, and net premium.
Verified employer industry and ownership eligibility, exercised judgment, negotiated, and made sound business decisions.
Reviewed employee enrollment/refusal forms, conducted potential client telephone interviews, reviewed medical records, and researched medical conditions.
Prepared requests to the group to provide missing, incomplete, and/or additional information necessary to complete the file.
Calculated figures and amounts such as commissions and percentages.
Prepared simple correspondence and routine reports.
Experience
5-7 Years
Level
Executive
Education
Diploma
Medical Underwriter Resume
Headline : Gathering claims history data from multiple sources, interprets and provides clinical judgment on diagnosis and estimates to the requestors regarding the impact on future potential claims.
Skills : Life Insurance Underwriting, Health Insurance Underwriting.
Description :
Responsible for accepting, rating, or declining applicants for life, health, and disability insurance.
Communicated with insurance agents and physician's offices with regard to the applicant's information via phone, letters, and emails.
Started work with the company as a data entry clerk, entering applicants information into a database, proofreading the underwriters work, and printing and sending out letters on a high-speed printer Accomplishments Starting as a data entry clerk and learning the business of insurance through this entry-level position made the transition of being promoted to an underwriter a bit easier during the classroom period.
Able to help the new underwriters that were in training with me to understand the working of the company, therefore, building a good working relationship within the department.
Reviewed medical claims and applications.
Met quotas, received consistent raises and bonuses.
Made suggestions that were implemented such as quick turnaround times and worked OT to facilitate sales.
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