Case Specialist Underwriting Tele-Services (Onsite)

Overview

Processes and reviews underwriting requirements by conducting customer interviews to gather non-medical and medical information. Works with some supervision but is empowered to approve applications and other decisions within the limits of authority level, and coordinates workflow of cases outside authority limits with Senior Case Specialist. Completes appropriate amendments, and thoroughly reviews and validates output to ensure accuracy. Ensures compliance rules regarding all requirements and procedures are completed. Research inquiries and provide prompt and accurate service to internal and external customers. Supports the overall goals of the department by meeting or exceeding department time service, production goals, quality standards and underwriting requirements.

Responsibilities

• Process contract and application changes and requests and approves and issues life and health insurance policies in a timely manner compliant with state and federal guidelines.
• Provide direction to internal and external customers on what documentation and forms that are needed to complete the application process through accurate and professional verbal communication.
• Conduct client interviews to obtain the most accurate answers to medical, social, avocation and other required information to aide in the completion of the underwriting process.
• Analyze and prepare cases for the New Business Specialists, Underwriting Assistants, Underwriters or Senior Underwriters to review.
• Develop and maintain confidentiality of information, including sensitive medical information and complies with federal and state rules and regulations (i.e., MIB, Fair Credit Reporting Act, Replacements, etc.).
• Utilize document management systems to organize, manage and transmit documents.
• Verify and process outstanding case requirements and process requests for additional information.
• Analyze and review for completeness and accuracy, codes the appropriate system to issue and approve the case within an established time service and quality guidelines.
• Investigate and gather information as needed for additional medical conditions based on clients responses.
• Back-up for Senior Case Specialist to handle day to day case management and reporting or perform other duties as assigned by management.

Qualifications

• Proven PC Skills and the ability to make repetitive motions of the wrists, hands and/or fingers.
• Demonstrated strong attention to detail with excellent organizational skills. Cite examples of organization and time management methods used to manage or prioritize work load demands.
• Demonstrated ability to make sound decisions during client interviews on which medical conditions or medications need further details, additional amendments or documentation that may not have been originally disclosed.
• Demonstrated experience working independently under little direction from management. Experience must include the ability to apply knowledge to future decisions ( progressive decision making).
• Demonstrated excellent verbal and written communication skills with the ability to successfully interpret and communicate business needs to internal and external customers in a clear, focused, and concise manner.
• Must provide examples of maintaining a high degree of accuracy associated with high volumes of work and or multiple duties.
• Demonstrated experience effectively working with customers.
• Must provide examples from work experience demonstrating flexibility to meet department and customer needs.
• Demonstrated experience working independently under little direction from management. Experience must include identifying and resolving problems where independent decision making, and self-initiative were demonstrated.

Work Setting:

• This position works in an office setting and remains in a stationary position for long periods of time while working at a desk, on a computer or with other standard office equipment, or while in meetings. 

• Position requires substantial movement of wrist, hands and fingers for continuous computer work.

Educational Requirements:

• High school diploma.
• Some college work preferred.
• 2 plus years relevant work experience in a life insurance or medical setting.

Computer Skills and Knowledge of Hardware & Software Required:

• Excellent PC skills with the ability to navigate multiple programs and systems.
• Working knowledge of word processing and spreadsheet applications.
• Working knowledge of email system.

Certifications & Licenses (i.e., Series 6 & 63, CPA, etc.):

• State life and health insurance license.
• Preferred Designation(s): Associates Degree with concentration in the medical field.
• Preferred Designation(s): LOMA, ALU or other Industry designations. 

Position Demands:

• Ability to work a flexible shift as required.
• Extended hours required during peak workloads or special projects.