GENERAL SUMMARY
Underwrites and rates routine to complex employer groups and ensures these groups remain on a profitable basis. Applies methods used to analyze data in order to determine financial requirements for prospective and renewal business. Performs routine underwriting tasks independently and complex duties under general supervision.
ESSENTIAL RESPONSIBILITIES
- Calculates standard and non-standard renewal and prospective employer group rates in accordance with regional rating rules and federal and state regulations.
- Gathers and examines appropriate documentation and data required to calculate and produce employer group rate renewal packages.
- Interprets actuarial data and applies judgment as to actuarial and underwriting considerations in appropriately pricing products.
- Evaluates the appropriateness of employer group rates. Monitors and enforces current underwriting policies as they relate to employer groups.
- Assists sales personnel in explaining rate calculations and underwriting policy if needed.
- Ensures the quality and integrity of account specific data and information released to the sales force.
- Ensures the timely completion of renewals, proposals, account reports and monthly departmental reports associated with the underwriting function.
- Calculates broker commissions and oversees and enforces broker payment procedures and rules for employer group rating.
- Serves as liaison with other departments for coordinated projects.
- Tests computer applications of new rating methods.
- Performs other duties as required.
Qualifications:
JOB SPECIFICATIONS
- Bachelor’s degree or equivalent experience.
- Previous (usually 2+ years) experience in underwriting or analytical experience.
- Knowledgeable of all federal and state laws and regulations regarding operation of the Program including licensure and audit of contractual services.
- Good understanding of the formula and basic underwriting principles.
- Knowledge of statistical and computer information systems.
- Knowledge of Medicare guidelines and previous experience related to Medicare underwriting is desirable.
Coventry Health Care is an Affirmative Action/Equal Opportunity Employer, and we are committed to building a talented and diverse team.
Job: Professionals
Primary Location: Pittsburgh, PA, US
Organization: 10900 - CMS - STAR Corporate
Schedule: Full-time
Job Posting: 2012-10-30 00:00:00.0
Job ID: 1212002