| | | 20,000+ Fresh Resumes Monthly | |
|
|
| |
Click here or scroll down to respond to this candidate Candidate's Name
th
Street Address
cell: PHONE NUMBER AVAILABLE email: EMAIL AVAILABLE
Talented underwriter with over twenty years of underwriting and new business
experience. I am seeking a position with a organization that will utilize my
professional skills and experience. Highly skilled in underwriting various product
lines including individual health, life, disability income and group size up to 100
lives. My understanding and knowledge of risk assessment and medical
terminology is solid.
PROFESSIONAL EXPERIENCE
Aetna, 2012 - 2013
Underwriting Specialist
Responsible for determining acceptability of insurance risks and
appropriate premium rates for employer groups 2-100 lives in accordance
with the underwriting guidelines.
Calculate rates for group cases based on industry - nature of business,
location, size and claims experience.
Process and issue prescreens and standard quotes.
Provide information to marketing, office assistants and brokers to explain the factors
affecting final proposal packages.
Health Net of Arizona, 2005 - 2010
Senior Underwriter 2007 - 2010
Review applications of applicants requesting individual health and life
insurance.
Responsible for approval, modification and declination of applicants.
Provided assistance to marketing regarding underwriting guidelines and
procedural issues.
Senior Rescission Analyst 2005 - 2007
Review underwriting file, questionnaires, intelliscript and medical records to
identify and investigate potential members for possible misrepresentation
subsequent to policy issue.
Prepare correspondence and notify members, brokers, physicians, and
attorneys during the investigation and risk selection process about
application discrepancies.
Facilitate, coordinate and schedule investigative committee meetings.
Communicated investigation decisions to appropriate departments.
Manage develop and implemented policies and procedures covering
rescission. Disseminated comprehensive reports using medical claims data,
and pharmacy data to support the compliance operation.
Support claim recovery department, initiate recoupment, assist in the
development and recovery to assure cost analysis and recovery expense was
tracked and reported.
Candidate's Name Page 2
AGIA, 2002 - 2005
Underwriter II
Responsible for risk assessment of individual health, disability income and individual
life applications with signature approval authority to five hundred thousand.
Requested and reviewed requirements such as client interviews, inspection reports,
MIB hits, paramedical exams laboratory data, medical records, motor vehicle
reports and criminal records.
Review applications to verify completeness.
Handle inquiries regarding policy, request for information, processed benefit
changes, cancellations and resolved policy issues.
Communicate with agents regarding status and requirements of pended cases.
Responsible for data entry of enrollment forms, tracked and maintained
departmental reports, issued and released policies.
Evaluate policy changes, conversions and reinstatements.
Communicated with marketing, applicants, medical director, physicians, and
reinsurance companies.
Health Net of Arizona, 2001 - 2002
Underwriter II
Analyzed information of applicants requesting individual health and
Medicare coverage and determined whether the risk was acceptable.
Investigate discrepancies and request additional information when
necessary to evaluate risk thoroughly.
Participate in strategic planning and project work that developed and
improved the underwriting process.
Underwriting representative during rescission meetings to provide insights
regarding underwriting guidelines.
EDUCATION AND TRAINING
B.S. Elementary Education, Southern Illinois University, Carbondale
Illinois
Regulatory & Fraud Seminars
Medical Terminology, ICD-9 and CPT Coding
LOMA Courses
Centers for Medicare and Medicaid Services Courses (CMS)
|
