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Cambia Health Underwriting I, II, III or Senior - R-4984_40483885656_2-4185 in Coeur d'Alene, Idaho

This job was posted by https://idahoworks.gov : For more information, please see: https://idahoworks.gov/jobs/2194334 Underwriting I, II, III or Senior

Work Remotely from Oregon, Washington, Idaho or Utah

Primary Job Purpose

Underwriter I, II, III & Senior evaluates each assigned group\'s risk and attaches the appropriate rate.

General Functions and Outcomes

Underwriter I (Entry Level)

  • Approves renewal changes after verifying rates and product selection.
  • Audits both new and renewing groups as necessary.
  • Determines rates for alternative benefit variations.
  • Ensures that group participation requirements are met.
  • Prepare rate filings.
  • Follows underwriting guidelines, policies, procedures and formulas in developing rates for new and renewal groups.
  • Gathers the appropriate data used to determine the status of account refunds.
  • Maintains spreadsheet information on group renewal history.
  • Prepares memos and other correspondence to communicate changes in rates or benefits which have been approved by underwriting management.
  • Processes the appropriate paperwork associated with renewal rate action and proposal closing.
  • Supports internal sales staff regarding underwriting questions and/or resolves issues.
  • Effectively communicates Underwriting decisions to other departments when necessary.

Underwriter II - In addition to the Functions and Outcomes Listed above for the UW I, the UW II, III & Senior...

  • May determine rates for alternative benefit variations and funding arrangements.
  • Assist in the training process and mentoring of more junior level Underwriters.
  • Prepares contingent premium settlements.
  • Prepares the rate quotations and completes bid specifications.
  • Processes group financial settlement calculations.
  • Reviews and determines whether or not to grant exception requests.
  • Supports management reporting efforts and the development of automated rating and analysis tools.

Underwriter III - In addition to the Functions and Outcomes Listed above for UW I & II, the III & Senior...

  • May determine rates for alternative benefit variations and more complex funding arrangements.
  • Actively involved in the preparation and maintenance of underwriting guidelines and rating policy.
  • Actively involved with testing new rating, underwriting and front end systems.
  • Answers questions regarding the basic factors used in developing rates, (group size, type of benefits, age/gender composition, large claims, experience provided from the prior carrier, current rates).
  • Answers questions regarding the rate model and how it impacts rates in accordance with particular group demographic changes.
  • Assesses health risk in a group environment (performs large claim analysis for ongoing claim cost).
  • Develops prospective and renewal rates for group accounts in accordance with corporate and underwriting guidelines.
  • Reviews and determines whether or not to grant exceptions to underwriting policy.
  • Ensures the proper administration of underwriting and legislative guidelines for new and renewing groups.
  • Handles large volume production with account specific issues (I.e. reinstatements, eligibility standards, group identification criteria, etc)
  • Maintains a working knowledge of State and Federal regulations affecting group rating.
  • Prepares rate breakouts and hierarchy definitions for group setups.
  • Reviews and directs the preparation of experience reports for fiscal, ERISA and contingent premium settlements.
  • May meet with external customers, brokers or account representatives to review underwriting calculations and provide explanations for rating principles.
  • May prepare written summaries of recommendations and/or conditions of overage for the group after completion of each analysis.
  • May prepare an explanation of the past rating history, documenting benefit and enrollment changes, and providing a recommendation for benefit and financial options.

Underwriter Senior - In addition to the Functions and Outcomes Listed above for UW I, II & III, the UW Senior...

  • Contributes to timely and accurate productivity by assisting the Manager in education to new Underwriters.
  • Attends broker meetings, as well as meetings with sales executives, agents and/or groups to provide explanations of rating principles or rationale of rating positions.
  • Contributes to the development of new rating formulas, methodologies and guidelines.
  • Represent underwriting on Cambia workgroups and strategy sessions and serves as department representative where applicable.

Minimum Requirements

Underwriter I

Demonstrated analytical and problem solving skills.

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