What are the responsibilities and job description for the Underwriter II position at AvMed Health Plans?
Embrace better opportunities.
Are you passionate about health, happiness and helping others? So are we. We’re committed to helping our health plan Members live a happy and healthy lifestyle, and we believe that it starts here first, with our Associates.
At AvMed, we provide the tools and opportunities to enhance, expand, and support each Associate’s personal and professional growth. From tuition reimbursement to exercise classes in the office, embrace a better career with AvMed and join our team!
Position: Underwriter II
Scope of position: Analyzes small and large group and member characteristics to determine group and member eligibility, participation, premium contribution requirements and appropriate risk.
Essential Job Functions:
- Processes small and large group new business prospects and renewals; ensures completion of required eligibility documentation; develops custom benefit relatives for group specific requests.
Reviews qualification information to determine compliance with statutory and underwriting requirements.
Uses system to determine appropriate risk adjustment factor.
Determines rate loads based on adverse diagnoses and claims.
Documents risk evaluation findings and maintains records for review by audit and regulatory authorities.
Tracks and reports monthly underwriting performance metrics.
Audits and reviews small group invoices to verify current enrollment; terminates non-responsive or non-compliant groups.
Reviews requests for group reinstatement and exception requests.
Coordinates the purge or off-site storage of old underwriting files.
Assists with training of new sales associates.
Collaborates with other departments on user testing to implement new products and processes, new rates, rating methodologies and applications; helps identify and resolve group and member issues.
Performs additional duties and responsibilities as assigned by management
We Offer:
- Competitive Salaries
- Comprehensive Benefits: Medical Plans, Health Savings Account, Dental, Vision, and more…
- Paid Time Off, Company Paid Holidays, Paid Time Off Cash-In
- 401(k)plan with matching contributions, Tuition Assistance, Associate Discounts
You have:
- Bachelor’s degree required
- 3-5 years of General underwriting, HMO or health insurance or related field.
You May Also Have:
- Health Insurance Portability and Accountability Act (HIPAA)-Proficiency: Advanced
- Manage Projects- Proficiency: Intermediate
- Problem Solving- Proficiency: Intermediate
- SQL, VBA and/or SAS- Proficiency: Beginner
- Microsoft Office (Word, Excel Access, Outlook)- Proficiency: Intermediate
Environment:
At AvMed, you’ll find a family. Our Associates love all the opportunities for advancement, the flexible work environment and team activities. We also encourage our Associates to embrace a life rich in what matters most — health and happiness. We call it being WELLfluent. Join AvMed. Join the WELLfluent!
Location:
Gainesville, Florida
This position is Hybrid 2 days in office and 3 days remote
AvMed is a tobacco/drug free workplace, EOE