Underwriter Senior, Geisinger Health Plan (Eastern United States EST / CST)
Job Summary
We are seeking a highly skilled and detail-oriented Senior Underwriter with strong expertise in Administrative Services Only (ASO), Stop Loss, and pharmacy risk evaluation to join our dynamic team. This role is critical in evaluating risk, pricing strategies, and ensuring sustainable growth across our self-funded product lines.
Job Duties
Calculates premium rate proposals and develops product portfolios for new client groups and renewal business. Contributes to the achievement of the financial and marketing objectives for the thorough assessment of group risk, the expected cost to deliver services, the expected marketability and competitiveness of health care services that will result in profitable enrollment. Uses actuarial data in standard application of various rating methodologies and formulas and identifies potential areas for application of underwriting judgment. Confers with management to identify and develop methods and procedures to obtain greater efficiency. Provides support to Management relative to financial forecasting, profitability and expense analysis, and assigned special projects.
- Coordinates the Group Information Card (GIC) process for the underwriting department.
- Contacts and follows up with the sales representative for outstanding GIC's or notices.
- Audits GICs for accuracy for first QA process Maintain GIC statistics for peak season meetings.
- Organizes Group Terminations and maintains relevant information, such as members, medical loss ratio and reason for termination.
- Prepares files for scanning.
- Acts as liaison between Underwriting and Corporate Imaging.
- Implements and maintains the records management program by complying with policy and procedures established for consistent use, maintenance, retention, preservation and destruction of Health Plan records Randomly selects files for departmental audits.
- Gathers files for the managers to audit.
- Makes sure essential information is in the file.
- Gathers information for Model Audit Rule Audits and coordinates the responses to internal audits.
- Processes and triages Medicare Supplement applications and complete auto denial applications.
Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.
#LI-REMOTE
Education
Associate's Degree- (Required)Experience
Minimum of 7 years-Related work experience (Required)Skills
Insurance Legal And Regulatory Environment; Insurance Finance And Actuarial ConceptsAbout Geisinger
Founded more than 100 years ago by Abigail Geisinger, the system now includes ten hospital campuses, a 550,000-member health plan, two research centers and the Geisinger Commonwealth School of Medicine. With nearly 24,000 employees and more than 1,700 employed physicians, Geisinger boosts its hometown economies in Pennsylvania by billions of dollars annually. Learn more at geisinger.org or connect with us on Facebook, Instagram, LinkedIn and Twitter.
Equal Opportunity Employer
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws.
Our Vision & Values
Everything we do is about making better health easier for our patients, our members, our students, our Geisinger family and our communities.
KINDNESS: We strive to treat everyone as we would hope to be treated ourselves.
EXCELLENCE: We treasure colleagues who humbly strive for excellence.
LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow.
INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
SAFETY: We provide a safe environment for our patients and members and the Geisinger family.
Our Benefits
We offer healthcare benefits for full time and part time positions from day one, including vision, dental and prescription coverage.
“I’ve been surprised by the community our floor has even though we can all work different days and different shifts. We celebrate successes and life events for employees and patients — that’s what makes it a fun place to work!”
Nurse Assistant
A place where you can lead a healthy lifestyle and follow your dreams.
Only at Geisinger.
Best employer for healthy lifestyles – National Business Group
Access to 121 state parks
