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GuideWell

Specialist II - Group Underwriting

Posted 2 Days Ago
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Remote or Hybrid
Hiring Remotely in United States
50K-82K Annually
Junior
Remote or Hybrid
Hiring Remotely in United States
50K-82K Annually
Junior
Performs complex group health insurance underwriting for new business and renewals covering groups of up to 299 contracts. Assesses medical and financial risk, calculates renewal rates, evaluates exceptions and pricing adjustments, prepares regulatory filings and financial reports, resolves rating issues, and supports Sales Representatives. The role also mentors junior underwriters, contributes to projects, and ensures compliance with underwriting guidelines, state and federal regulations, and quality deadlines.
The summary above was generated by AI

The Unassigned Group Underwriting team is the unit within Group Underwriting that exclusively supports the Mid-size Group and new business quotes and Renewal process. This position is responsible for groups up to 299 contracts with a high degree of complexity. The Specialist II Group Underwriting position is responsible for new business group underwriting for unassigned groups, alternate rates, pricing policy adjustments and exceptions to field rating which result in applying a rating factor The position is also responsible for renewal underwriting, including updated renewal calculation for unassigned business, alternate rates, funding, IRS form 5500 & annual accountings, and pricing policy adjustments.

Job duties include but are not limited to:
•    Assess 51-299 Exception Requests for new business
•    Risk assessment based on medical information
•    Ensure groups meet Underwriting Guidelines
•    Perform analysis of new groups previously enrolled
•    Assess Pricing Policy Adjustment requests
•    Prepare weekly underwriter’s report 
•    Prepare monthly reports with detailed analysis
•    Analyze data to determine group renewal rates
•    Prepare Proshare Settlements and annual accountings
•    Prepare 5500’s
•    Prepare rate for Non-Standard and customer option requests
•    Prepare monthly unassigned renewal Underwriter report 
•    Collaborate with Sales Reps to assist their understanding of rates
•    Research and resolve escalated rating issues
•    Informal one-on-one training with Sales Representatives
•    Participation in formal and informal projects
•    Mentoring of lower-level underwriters and assist with clarification
•    Achieve self-development goals

Job Requirements:
•    2+ years related work experience. Experience Details: Claim analysis and projection on the job experience; working experience with group health insurance products, pricing, financing, underwriting and marketing strategies
•    Related Bachelor’s degree or additional related equivalent work experience 
•    Knowledge of state and federal statutes and regulations
•    Understanding of underwriting philosophy, fundamentals and principles 
•    Excellent understanding of contracts 
•    Thorough knowledge of the Company's systems and ability to modify or develop new procedures to meet specialized needs 
•    Ability to interpret and analyze medical and other underwriting data 
•    Process and technical proficiency of various underwriting systems that support the group underwriting and renewal processes. These systems include but are not limited to: Siebel, E-rate, Renewal Rating Tool, MBI, Milliman GRx, Alternate Tool, Demographic Tool and RBMS
•    Experience in the Microsoft Office Suite (i.e. Excel, Word, Power Point)
•    Proficient in use of SharePoint 
•    Excellent computer skills 
•    Excellent written and verbal communication skills
•    Ability to quickly learn new or enhanced system functionalities and capabilities and business process flows 
•    Strong multi-tasking skills self-motivated and directed
•    Must be responsive, detail-oriented and able to meet established quality audit deadlines
•    Flexibility 
•    Ability to systematically review and consider alternatives in order to make good judgments 
•    Must enjoy a fast-paced team environment 
•    Ability to work under time pressure 
•    Ability to persuade and negotiate 
•    Strong business acumen 
•    High degree of personal motivation

Preferred:
•    Bachelor’s degree in Math, Insurance, Risk Management or Business 
•    Master’s degree in a related field 
General Physical Demands
Sedentary work: Exerting up to 10 pounds of force occasionally to move objects. Jobs are sedentary if traversing activities are required only occasionally.

This position offers a hybrid work arrangement which combines flexibility with in-office engagement. Team schedules are determined based on role requirements and business needs. Travel to and from our corporate or regional offices may be required.

What We Offer: 
As a Florida Blue employee, you will be at the heart of GuideWell’s vision – to lead the nation in transforming health through compassionate, connected, and technology-enabled care that delivers personalized value and empowered living.

To support your wellbeing, comprehensive benefits are offered. As an employee, you will have access to: 
•    Medical, dental, vision, life and global travel health insurance;
•    Income protection benefits: life insurance, short- and long-term disability programs;
•    Leave programs to support personal circumstances;
•    Retirement Savings Plan including employer match;
•    Paid time off, volunteer time off, 10 holidays and 2 well-being days;
•    Additional voluntary benefits available; and
•    A comprehensive wellness program

Employee benefits are designed to align with federal and state employment laws. Benefits may vary based on the state in which work is performed. Benefits for intern, part-time and seasonal employees may differ.

To support your financial wellbeing, we offer competitive pay as well as opportunities for incentive or commission compensation. We also conduct regular annual reviews with pay for performance considerations for base pay increases.

Annualized Salary Range: $50,300 - $81,800

Typical Annualized Hiring Range: $50,300 - $62,900

Final pay will be determined with consideration of market competitiveness, internal equity, and the job-related knowledge, skills, training, and experience you bring.

We are an Equal Employment Opportunity employer committed to cultivating a work experience where everyone feels like they belong and can perform at their best in pursuit of our mission. All qualified applicants will receive consideration for employment.

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