Individual Underwriter

Position Description

Base pay is influenced by several factors including a candidate’s qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with internal pay equity and external market driven rates. The salary range displayed has not been adjusted for geographical location. This range has been created in good faith based on information known to Capital Blue Cross at the time of posting and may be modified in the future. Capital Blue Cross offers a comprehensive benefits packaging including Medical, Dental & Vision coverage, a Retirement Plan, generous time off including Paid Time Off, Holidays, and Volunteer time off, an Incentive Plan, Tuition Reimbursement, and more.  

At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.”    

The position is responsible for reviewing group renewals and prospect quotes, providing rate recommendations, and calculating customer settlements. This position supports the review of medically underwritten Medicare supplement applications to assess risk by evaluating medical information using Capital Blue Cross underwriting guidelines, policies, procedures, and underwriting judgment.

This position also supports other financial functions within the unit. Mathematical, financial and analytical skills are utilized to research data and formulate appropriate proposals and recommendations to achieve business objectives. Written and verbal communication skills, along with subject matter expertise, are used to support a consultative approach directed at understanding and meeting customer needs.

Responsibilities and Qualifications

• Review renewals and rate exception requests. Complete appropriate analysis to support recommendations for rate actions and present to management for review and approval.
• Review rate exception requests for prospect groups. Complete appropriate analysis to support recommendations for rate actions and present to management for review and approval.
• Consult with Sales, Sales Management and Underwriting Management in support of renewal rate actions and quotes.
• Review financial contract language prior to settlement calculations.
• Review settlement calculations and research unusual results. Clearly document findings.
• Review applications, assess results, and recommend rating decision.
• Respond to inquiries concerning underwriting decision.

Skills:

• Strong analytical skills and a sound understanding of medical, enrollment, and claims data.
• Ability to abstract a financial arrangement into theoretical mathematical structures and determine financial consequences of the arrangement.
• Ability to effectively explain technical issues both verbally and in writing to department management staff.

Knowledge:

• Familiarity of financial and accounting concepts, terminology, and reports.
• Knowledge of Microsoft Office products.

Experience:

• Minimum of 3 years' experience in an operational role or an associate or bachelor’s degree.

Physical Demands:

• While performing the duties of the job, the employee is frequently required to sit, use hands and fingers, talk, hear, and see.
• The employee must occasionally lift and/or move up to 5 pounds.

About Us

We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital you will work alongside a diverse and caring team of supportive colleagues and be encouraged to volunteer in your community.  We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career.      And by doing your best, you’ll help us live our mission of improving the health and well-being of our members and the communities in which they live.