Associate Medical Stop Loss Underwriter

Highmark Health - Springfield, IL

Full-time - Entry Level

Springfield, IL

Insurance Carriers and Related Activities

About the position

The Associate Medical Stop Loss Underwriter position at Highmark Health involves pricing quotes and analyzing the structure of contracts for groups based on various factors such as claims experience and employee group characteristics. The incumbent will develop and exercise discretion in underwriting authority within the policies of HM Insurance Group (HMIG), ensuring appropriate levels of profitability and growth over time. This role requires the identification of quotes that do not align with HMIG's overall strategy and risk structure. The underwriter will analyze risk factors for new enrollments, annual renewals, and amendments of group insurance contracts or self-funded plans, adhering to established underwriting policies, practices, and standards. In this entry-level position, the underwriter will analyze associated policies, guidelines, and market data to continuously improve risk management and effectively manage existing membership. The role involves analyzing data such as the financial conditions of organizations, participation percentages, industry types, employee group characteristics, and past claim experiences to determine the benefits that can be offered and to set appropriate rates. The underwriter will prepare various reports and provide rationale and support to other areas within the organization, clients, and possibly producers regarding underwriting results, rate computations, and financial activity. The position is designed for individuals who are new to the field, with oversight provided by Senior Underwriters and/or Management until the individual becomes acclimated to the company's procedures, policies, and protocols. The underwriter will be responsible for managing a book of business, ensuring profitable levels of new business and renewals, and utilizing various systems and tools to obtain necessary data and track assigned work accurately. The role requires adaptability to changing priorities and the ability to communicate recommendations effectively to accommodate client-specific situations.

Responsibilities

• Price quotes and analyze the structure of contracts for groups based on claims experience and employee group characteristics.
• Develop and exercise discretion in underwriting authority within HMIG policies to ensure profitability and growth.
• Identify quotes that do not fit into HMIG's overall strategy and risk structure.
• Analyze risk factors for new enrollments, annual renewals, and amendments of group insurance contracts or self-funded plans.
• Prepare reports and provide rationale and support regarding underwriting results, rate computations, and financial activity.
• Calculate rates and interpret pricing policy, adapting to unusual situations as necessary.
• Identify questionable claim patterns and develop recommendations for renewal clients and prospects.
• Ensure compliance with corporate risk management policies and adjust pricing for unique situations.
• Analyze member risk and engage internal departments to manage this risk effectively.
• Support internal initiatives related to fraud detection, corporate compliance, and product development efforts.
• Complete renewals and prospect quotes in accordance with production and timeliness standards.
• Communicate recommendations for policy adaptations to accommodate client-specific situations.

Requirements

• Bachelor's Degree in Mathematics, Actuarial Science, Finance, Business, Computer Science, or other quantitative analysis discipline.
• 0 - 2 years of experience in Insurance, Underwriting of Self-Funded and/or fully insured prospects preferred.
• Developing understanding of various internal departments and external stakeholder interactions.
• Ability to use applicable computer systems, electronic tools, and applications.
• Ability to work independently and assume responsibility for routine projects.
• Demonstrate ethical business practices with adherence to privacy and confidentiality policies.
• Good problem-solving, organizational, and negotiation skills.
• Excellent math aptitude required for analysis.