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Underwriter I, II, III or Senior

Cambia Health Solutions

Underwriter I, II, III Or SeniorHybrid role (3 days/week in office) at our Salt Lake City, Boise, Portland, Vancouver, Renton, Medford, Burlington, Lewiston offices. Preference will be given to current employees and candidates who reside within a commutable distance from our Salt Lake City, Boise, and Lewiston offices or who are willing to relocate.Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system.Who We Are Looking For:Every day, Cambia's dedicated team of Underwriters is living our mission to make health care easier and lives better. As a member of the Underwriters team, our Underwriters Evaluate assigned group eligibility and risk and assign the appropriate rate for new and renewal groups across small and large group segments – all in service of creating a person-focused health care experience.Do you have a passion for serving others and learning new things? Do you thrive as part of a collaborative, caring team? Then this role may be the perfect fit.What You Bring to Cambia:Qualifications:Underwriter IBachelor's degree in business, math, statistics, or related discipline; or equivalent combination of education and experience.Underwriter IIBachelor's degree in business, math, statistics, or related discipline and a minimum of 3 years of related experience; or equivalent combination.Underwriter IIIBachelor's degree in business, math, statistics, or related discipline and a minimum of 5 years of related experience; or equivalent combination.Underwriter SeniorBachelor's degree in business, math, statistics, or related discipline and a minimum of 8 years of related experience; or equivalent combination.Skills and Attributes:Demonstrated analytical and problem-solving skills.Business acumen including finance, accounting, economics, and risk management principles.Effective verbal and written communication skills.Ability to build and maintain positive internal and external customer interactions.Ability to prioritize tasks and meet deadlines.Demonstrated technology proficiency, including Excel, Word, and applicable software applications.Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desiredAdditional Minimum Requirements for level IIDemonstrated success managing competing priorities and workload.Ability to work independently, meet deadlines, and achieve standards.Proven attention to detail and accuracy in data entry and other administrative tasks.Understanding of fundamental negotiation principles and company policies.Additional Minimum Requirements for level IIIDemonstrated proficiency working with complex computer software systems and automation.Ability to effectively explain complex mathematical and abstract concepts to a variety of stakeholders, including those with less familiarity or understanding.Advanced knowledge of healthcare benefits and programs.Confidence in presenting terms and defending underwriting decisions.Strong problem-solving skills with the ability to investigate and resolve complex issues.Additional Minimum Requirements for Senior levelProven understanding of business, including finance, accounting, economics, and risk management.Demonstrated attainment of a high level of independent, consistent performance.Ability to organize, plan, prioritize, and complete complex assignments with little or no supervision.Ability to document processes and procedures.Demonstrated ability to read the marketplace and competitive environment.Expertise in alternate funding arrangements and underwriting policies and procedures.What You Will Do at Cambia:Follow underwriting guidelines, policies, procedures, and formulas in developing and assigning rates for new and renewal groups, including alternative benefit variations and complex funding arrangements.Verify employer eligibility to purchase and renew group products, ensuring all groups meet minimum participation and contribution requirements.Audit new and renewing groups as necessary to ensure compliance with underwriting and legislative guidelines.Validate that all required documentation received is complete and properly executed.Approve renewal changes after verifying rates and product selection.Maintain complete and accurate records and documentation in underwriting systems.Identify and resolve data discrepancies and processing errors.Monitor application status and ensure timely processing through workflow systems.Gather appropriate data to determine the status of account refunds.Maintain spreadsheet information on group renewal history.Use independent judgment, or judgment with appropriate level of peer/manager review, to evaluate system-generated rate calculations for reasonability.Utilize applications to support the rating and underwriting process, including but not limited to StepWise, Salesforce, claims systems, and other reporting databases.Prepare memos and other correspondence to communicate changes in rates or benefits.Process appropriate paperwork associated with renewal rate actions and proposal closings.Maintain a working knowledge of State and Federal regulations, including the Affordable Care Act, affecting group rating.Additional General Functions and Outcomes for level IIAssist in training more junior level Underwriters.Work independently to prioritize work, meet deadlines, and achieve standards.Prepare retrospective settlements.Analyze reinstatement requests to grant or deny approval.Advise internal teams on underwriting questions and issue resolution.Support management reporting efforts and the development of automated rating and analysis tools.Develop and prepare federal and state reporting documents.Answer questions regarding the basic factors used in developing rates.Additional General Functions and Outcomes for level IIIProactively suggest alternative benefit options and determine rates for alternative benefit variations and more complex funding arrangements.Support all types of group clients, including self-funded companies, associations, and national accounts.Actively participate in the review and maintenance of underwriting guidelines.Conduct user acceptance testing of underwriting and front-end systems.Provide training to non-underwriting departments, including Sales, on underwriting policies and procedures as necessary.Use independent judgment to evaluate system-generated rate calculations for reasonability.Answer questions regarding the factors used in developing rates, including group size, type of benefits, age/gender composition, large claims, experience from prior carriers, and current rates.Analyze large claims to proactively identify risk patterns and develop accurate pricing models.Assess health risk in a group environment, including large claim analysis for ongoing claim costs.Review and determine whether to grant exceptions to underwriting policy.Ensure proper administration of underwriting and legislative guidelines for new and renewing groups.Handle large volume production with account-specific issues (e.g., reinstatements, eligibility standards, group identification criteria).Prepare rate breakouts and hierarchy definitions for group setups.Review and direct the preparation of experience reports for fiscal, ERISA, and retrospective premium settlements.May prepare written summaries of recommendations and/or conditions of coverage following each analysis.May prepare explanations of past rating history, documenting benefit and enrollment changes, and providing recommendations for benefit and financial options.Additional General Functions and Outcomes for Senior levelAssist the Manager in the education and support of new and junior Underwriters.Leverage expertise in alternative funding models and benefit packages to proactively identify solutions and analyze potential risk.Craft clear communications to Sales documenting underwriting decisions.May attend broker meetings, as well as meetings with sales executives, agents, and/or groups to provide explanations of rating principles or rationale of rating positions.Research and resolve complex group eligibility questions.Recommend solutions to improve procedures and processes.Contribute to the development of new rating formulas, methodologies, and guidelines.Champion best practices as a subject matter expert.Represent underwriting on cross-functional workgroups and strategy sessions, serving as a department representative.Work Environment

Vacancy posted 2 days ago
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