Underwriting Administration Specialist

About the role

Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.

Responsibilities

• Underwriting Administration Specialist
• Reviews and processes new group and benefit changes in accordance with departmental policies and procedures.
• Ensures accurate coding of account worksheets and other documents in order to reflect proper rates and terms as well as compliance with underwriting regulatory requirements/laws.
• Reviews and processes new submissions for all channels within the Small Group Market Segments, ACA Individual, Medicare Supplement and Short-Term Individual policies for completeness and compliance with underwriting regulatory requirements/laws, if applicable.
• Responds to underwriting and administrative email and telephone inquiries.
• Handles workflow distribution involving multiple departments and mailboxes per established procedures.
• Establishes and maintains work logs and records needed for management reporting.
• Performs other duties as assigned.
• Senior Underwriting Administration Specialist
• Reviews and processes new group and benefit changes in accordance with departmental policies and procedures.
• Ensures accurate coding of account worksheets and other documents in order to reflect proper rates and terms as well as compliance with underwriting regulatory requirements/laws.
• Reviews and processes new submissions for all channels within the Small Group Market Segments, ACA Individual, Medicare Supplement and Short-Term Individual policies for completeness and compliance with underwriting regulatory requirements/laws, if applicable.
• Manages workflow distribution including multiple departments, mailboxes, and systems. Ensures turnaround goals are achieved.
• Identifies and assists with problem resolution within scope of authority. Interprets if escalation to management needed.
• Trains more junior level administrative staff and conducts peer reviews/audits on processes.
• Led status meetings and coordinates daily queue assignments.
• Prepares and summarizes work logs and records for management review.
• Participates in the testing of the quoting and renewal systems to ensure rates are properly calculating, accuracy of exhibits, and quality assurance prior to release for external customers.
• Documents workflows and processes. Updates underwriting procedures for new state and federal laws/regulations per corporate direction.
• Identifies continuous improvement opportunities.
• Performs other duties as assigned.

Qualifications

• Underwriting Administration Specialist:
• Education And Experience: Associate Degree in Business or Healthcare Administration or related field or equivalent combination of experience, training, and education. 3 years health plan sales or operations experience or equivalent customer service or office support experience in health care or financial services.
• Technical Skills And Knowledge: Knowledge of standard office procedures and equipment operation (multi-function copier, multi-line phone, etc.). Intermediate Microsoft Office (Word, Excel) and general database management/reporting skills. Knowledge of health insurance products and underwriting operations. Basic knowledge of general health plan regulations. Good math skills. Good customer service skills.
• Senior Underwriting Administration Specialist:
• Education And Experience: Associate Degree in Business or Healthcare Administration or related field or equivalent combination of experience, training, and education. 5 years of experience as an Underwriting Administration Specialist or equivalent health plan sales or operations experience.
• Technical Skills And Knowledge: Knowledge of standard office procedures and equipment operation (multi-function copier, multi-line phone, etc.). Intermediate Microsoft Office (Word, Excel) and general database management/reporting skills and basic knowledge of health insurance underwriting systems. Knowledge of health insurance products and underwriting operations. Knowledge of standard health insurance underwriting formulas and related Company policies and procedures. Strong math skills. Strong customer service and training skills.