Underwriting Analyst

Blue Cross and Blue Shield of Kansas is looking to add to our Underwriting team and has a new opportunity for an Underwriting Analyst. This position Analyst is responsible for evaluating risk and eligibility for employer groups and individual business, ensuring compliance with underwriting guidelines and regulatory requirements. This role plays a critical part in assessing health risk, reviewing enrollment eligibility, and supporting underwriting decisions to mitigate financial risk. The analyst collaborates with Sales, Membership, Rating, Actuarial, Legal, and Compliance teams to ensure adherence to corporate policies, industry regulations, and risk assessment best practices.

“This position is eligible to work remotely (8 or less days a month onsite) or hybrid (9 or more days a month onsite) in accordance with our Telecommuting Policy. Applicants must reside in Kansas or Missouri or be willing to relocate as a condition of employment.”

• Family Comes First: Total rewards package that promotes the idea of family first for all employees; including paid time off and family first leave.
• Professional Growth Opportunities: Advance your career with ongoing training and development programs both through our internal Blue University and external opportunities.
• Make a Positive Impact: Your work will directly contribute to the health and well-being of Kansans.
• Stability: 80 years of commitment, compassion, and community

• Blue Cross and Blue Shield of Kansas offers excellent competitive compensation with the goal of retaining and growing talented team members. The compensation range for this role is a good faith estimate, it is estimated based on what a successful candidate might be paid. All offers presented to candidates are carefully reviewed to ensure fair, equitable pay by offering competitive wages that align with the individual's skills, education, experience, and training. The range may vary above or below the stated amounts.

• Evaluate group and individual applications to ensure compliance with underwriting eligibility and participation requirements.
• Assess health risk factors for individuals and employer groups, analyzing claims history and financial impact.
• Conduct re-rate reviews for groups with census changes, ensuring alignment with underwriting policies.
• Serve as a liaison between underwriting and Sales, Membership, Legal, and Compliance, ensuring clear and consistent communication of underwriting decisions.
• Maintain accurate records and documentation for audits and regulatory compliance.
• Investigate complex eligibility cases, including rescission reviews, coordinating with legal and compliance as needed.
• Provide underwriting guidance and training to internal teams on enrollment, eligibility, and underwriting policies.
• Conduct quality assurance reviews of underwriting decisions to identify trends and improve processes.
• Support the development and maintenance of underwriting policies and procedures to ensure compliance with ACA, COBRA, ERISA, and other regulations.
• Assist with rate justifications and regulatory filings as needed.

• Minimum of 3 years of experience in underwriting, enrollment risk assessment, or a related field in the health insurance industry.
• Knowledge of medical terminology required.
• Ability to work in an office environment and use standard office equipment.
• Extended periods of sitting and computer use may be required.

• Strong analytical skills to assess risk, evaluate claims data, and make sound underwriting decisions.
• Proficiency in medical terminology, risk assessment methodologies, and underwriting guidelines.
• Understanding of state and federal regulations, including ACA, COBRA, and ERISA.
• Excellent written and verbal communication skills to explain underwriting decisions and collaborate with internal and external stakeholders.
• Strong problem-solving skills to investigate complex enrollment and eligibility cases.
• Ability to work independently while managing multiple priorities in a fast-paced environment.
• Proficiency in Microsoft Office applications (Word, Excel, Outlook) and familiarity with underwriting and enrollment systems.
• Attention to detail and strong organizational skills to ensure compliance and accurate recordkeeping.

• Bachelor's degree in Business, Finance, Healthcare Administration, or a related field preferred.
• Preferred LPN, Certified Nurses Aid or Certified Medical Aid and/or experience in a clinical setting or coding medical records using ICD 9 or 10 methodologies.
• Experience working with group rating, underwriting policies, and regulatory compliance preferred.
• Medical terminology coursework or experience in medical claims review is preferred.

• Base pay is only one component of your competitive Total Rewards package:
  • Incentive pay program (EPIP)
  • Health/Vision/Dental insurance
  • 6 weeks paid parental leave for new mothers and fathers
  • Fertility/Adoption assistance
  • 2 weeks paid caregiver leave
  • 5% 401(k) plan matching
  • Tuition reimbursement
  • Health & fitness benefits, discounts and resources