Underwriting Specialist

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.

Job Summary:

Under general supervision, supports health insurance sales and underwriting teams with administration of new and existing accounts in one or more of the following assigned market segments: large or small group, individual, government programs.


Responsibilities:

Underwriting Specialist

• Based on market segment assignment:
• 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.
• and/or
• 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 Specialist

• Based on market segment assignment:
• 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.
• and/or
• 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. Leads 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 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 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.

Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes:

A Great Place to Work:

• We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset.
• Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more.
• On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters.
• Discounts at many places in and around town, just for being a Medical Mutual team member.
• The opportunity to earn cash rewards for shopping with our customers.
• Business casual attire, including jeans.

Excellent Benefits and Compensation:

• Employee bonus program.
• 401(k) with company match up to 4% and an additional company contribution.
• Health Savings Account with a company matching contribution.
• Excellent medical, dental, vision, life and disability insurance - insurance is what we do best, and we make affordable coverage for our team a priority.
• Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits.
• Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time.
• After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption.

An Investment in You:

• Career development programs and classes.
• Mentoring and coaching to help you advance in your career.
• Tuition reimbursement up to $5,250 per year, the IRS maximum.
• Diverse, inclusive and welcoming culture with Business Resource Groups.

About Medical Mutual:

Medical Mutual's status as a mutual company means we are owned by our policyholders, not stockholders, so we don't answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us.

There's a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide 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. Our plans provide peace of mind to more than 1.2 million Ohioans.

We're not just one of the largest health insurance companies based in Ohio, we're also the longest running. Founded in 1934, we're proud of our rich history with the communities where we live and work.

We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.