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Underwriting Spec I/II/III - 003054

Location
Utica, NY

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u003cpu003eThe Lifetime Healthcare Companies aim to attract the best talent from diverse socioeconomic, cultural and experiential backgrounds, to diversify our workforce and best reflect the communities we serve. u003cbr /u003eu003cbr /u003eOur mission is to foster an environment where diversity and inclusion are explicitly recognized as fundamental parts of our organizational culture. We believe that diversity of thought and background drives innovation which enables us to provide leading-edge healthcare insurance and services. With that mission in mind, we recruit the best candidates from all communities, to diversify and strengthen our workforce. u003cbr /u003eu003cbr /u003eOUR COMPANY CULTURE: u003cbr /u003eEmployees are united by our Lifetime Way Values u0026amp; Behaviors that include compassion, pride, excellence, innovation and having fun! We aim to be an employer of choice by valuing workforce diversity, innovative thinking, employee development, and by offering competitive compensation and benefits.u003c/pu003enu003cpu003eSummary u003cbr /u003eThis Specialist position reviews the Annual Group Information form (AGIF), new groups with tax documents, benefit changes, status changes as well as member applications to ensure that they comply with the Underwriting regulations as well as federal/state regulations. u003cbr /u003e u003cbr /u003eEssential Responsibilities/Accountabilities u003cbr /u003eLevel I: u003cbr /u003eu0026bull; Completes entries into various data bases for tracking, reporting, and monitoring purposes. u003cbr /u003eu0026bull; Logging, scanning, and creating activities for assignment of work. u003cbr /u003eu0026bull; Schedule conference rooms, order department supplies, submit requests for phone message notifications create security requests and take and distribute meeting minutes as assigned. u003cbr /u003eu0026bull; Support retroactive requests by creating claim adjustment forms, reviewing additional information, and screening the request for the Underwriter. u003cbr /u003eu0026bull; Reviews group/member applications or change forms to ensure accuracy, completeness and adherence to corporate Underwriting guidelines, as well as federal and state laws/regulations. u003cbr /u003eu0026bull; Identifies and follows-up on cases where additional information is needed or conducts further research if necessary. u003cbr /u003eu0026bull; Reviews benefit changes, basic new groups, status changes, routine annual group information forms and HNY recertification groups to ensure they are compliant with the underwriting guidelines. u003cbr /u003eu0026bull; Meets and maintains underwriting quality and quantity standards established by supervisor. u003cbr /u003eu0026bull; Coordinates and resolves underwriting issues in conjunction with Membership, Customer Service, Marketing Operations and Sales. When fraud is suspected, refers case to the Special Investigation Unit. u003cbr /u003eu0026bull; Prepares Presentations on basic underwriting training topics and presents to the Underwriting team. u003cbr /u003eu0026bull; Processes Siebel, Intelligroup and Sale-to-Mail, requests originating from the Sales department. Processes and researches information regarding membership, benefits and claims information on multiple mainframe systems such as LRSP, FACETS, MABIL, U-WIN. u003cbr /u003eu0026bull; Researches and utilizes information on Siebel databases, Dun and Bradstreet reports, the internet and other alternative sources of information as necessary and/or as requested by management. u003cbr /u003eu0026bull; Resolves basic internal/external customer inquiries by phone or e-mail in accordance with the underwriting guidelines and federal/state laws/regulations. Exercises tact, patience, professionalism and perspective at all times in responding to internal/external customers, regardless of the issue or the customeru0026rsquo;s demeanor. u003cbr /u003eu0026bull; Assist with ad hoc projects and all other duties as assigned by management u003cbr /u003eu0026bull; Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companiesu0026rsquo; mission and values and adhering to the Corporate Code of Conduct. u003cbr /u003eu0026bull; Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures. u003cbr /u003eu0026bull; Regular and reliable attendance is expected and required. u003cbr /u003eu0026bull; Performs other functions as assigned by management. u003cbr /u003e u003cbr /u003eLevel II: In addition to Level I responsibilities, will enhance skills with the following: u003cbr /u003eu0026bull; Reviews group/member/AGIF enrollment documents for coverage using knowledge and expertise of Underwriting guidelines and state/federal regulations. u003cbr /u003eu0026bull; Prepares presentations on basic underwriting training topics as requested by management and presents to internal customers such as Sales, Membership, etc. u003cbr /u003eu0026bull; Reviews and responds to basic retroactive requests. u003cbr /u003eu0026bull; Acts as a resource to support lower level Underwriting Processors on any underwriting guidelines state/federal regulations and procedures. u003cbr /u003eu0026bull; Prepares and sends correspondence as directed by Management or Underwriters. Assists with the development of Chamber Trust and Association (CTA), broker blasts or Sales Communications. u003cbr /u003eu0026bull; Resolves basic/complex internal/external customer inquiries by phone or e-mail in accordance with the underwriting guidelines and federal/state laws/regulations. Exercises tact, patience, professionalism and perspective at all times in responding to internal/external customers, regardless of the issue or the customeru0026rsquo;s demeanor. u003cbr /u003eu0026bull; Responsible for knowledge and accuracy on mid-level underwriting u003cbr /u003eu0026bull; Responds to basic questions regarding Underwriting rules and procedures. Assists with answering questions from Sales, Acct Service, Membership, CTA administrators, etc. u003cbr /u003e u003cbr /u003eLevel III: In addition to Level II responsibilities, will enhance skills with the following: u003cbr /u003eu0026bull; Underwrites complex groups and reviews, tax documents, etc. May be considered a subject matter expert who provides advice and counsel on underwriting guidelines, regulations and the underwriting/enrollment process. u003cbr /u003eu0026bull; Prepares presentations and presents to our internal/external customers including but not limited to CTA group administrators, Sales Representatives, etc. u003cbr /u003eu0026bull; Independently answers underwriting mailbox questions. Responds to questions regarding Underwriting rules and procedures. u003cbr /u003eu0026bull; Works independently on projects as assigned. u003cbr /u003eu0026bull; Conduct basic audits and high risk review AGIFu0026rsquo;s. u003cbr /u003eu0026bull; Handles basic and complex calls and emails from brokers, Sales, Acct service, Membership and CTA administratoru0026rsquo;s with minimal assistance. u003cbr /u003eu0026bull; Trains new hires and temporary employees on the Underwriting guidelines and enrollment process, etc. u003cbr /u003eu0026bull; Meets and frequently exceeds underwriting quality and quantity standards established by supervisor u003cbr /u003e u003cbr /u003eMinimum Qualifications u003cbr /u003eNOTE: u003cbr /u003eWe include multiple levels of classification differentiated by demonstrated knowledge, skills, and the ability to manage increasingly independent and/or complex assignments, broader responsibility, additional decision making, and in some cases, becoming a resource to others. In addition to using this differentiated approach to place new hires, it also provides guideposts for employee development and promotional opportunities. u003cbr /u003e u003cbr /u003eAll levels: u003cbr /u003eu0026bull; AAS degree in Math, Economics or Business related field with a minimum of one yearu0026rsquo;s related experience. u003cbr /u003eu0026bull; Basic knowledge of Underwriting rules and principles. u003cbr /u003eu0026bull; Basic knowledge of health products and alternate financial arrangements available. u003cbr /u003eu0026bull; Basic knowledge of federal/state laws/regulations relating to health insurance, such as COBRA, Medicare, HIPAA, Small Group Reform, Affordable Care Act, etc. u003cbr /u003eu0026bull; Basic knowledge of federal/state tax forms and different business structures such as sole prop, tax exempt organizations, partnerships, limited liability companies, etc. u003cbr /u003eu0026bull; PC skills required: u003cbr /u003eo Beginner level in Microsoft Excel u003cbr /u003eo Proficient in Microsoft Word u003cbr /u003eo Ability to navigate on the internet for research purposes. u003cbr /u003eo Knowledge of Cognos or other data extraction tool u003cbr /u003eo Lotus Notes u003cbr /u003eo PowerPoint u003cbr /u003eu0026bull; Must possess excellent written and verbal communication skills. u003cbr /u003eu0026bull; Solution orientated u003cbr /u003eu0026bull; Ability to work independently and prioritize work in accordance with department guidelines u003cbr /u003eu0026bull; Demonstrates strong attention to detail and follow through. u003cbr /u003eu0026bull; Ability to handle confidential and sensitive information, such as tax returns, with discretion is essential. u003cbr /u003eu0026bull; Willingness to take initiative to identify process and other improvements u003cbr /u003eu0026bull; Must have the ability to travel. u003cbr /u003e u003cbr /u003eLevel II, in addition to above qualifications: u003cbr /u003eu0026bull; AAS degree in Math, Economics or Business related field with a minimum three years related experience. u003cbr /u003eu0026bull; Moderate knowledge of Underwriting rules and principles. u003cbr /u003eu0026bull; Moderate knowledge of health products and alternate financial arrangements available. u003cbr /u003eu0026bull; Moderate knowledge of federal/state laws/regulations relating to health insurance, such as COBRA, Medicare, HIPAA, Small Group Reform, Affordable Care Act, etc. u003cbr /u003eu0026bull; Moderate knowledge of federal/state tax forms and different business structures such as sole prop, tax exempt organizations, partnerships, limited liability companies, etc. u003cbr /u003eu0026bull; PC skills required: u003cbr /u003eo Moderate level in Microsoft Excel u003cbr /u003eo Proficient in Microsoft Word u003cbr /u003eo Ability to navigate on the internet for research purposes. u003cbr /u003eo Knowledge of Cognos or other data extraction tool u003cbr /u003eo Lotus Notes u003cbr /u003eo PowerPoint u003cbr /u003eu0026bull; Basic Presentation skills. u003cbr /u003e u003cbr /u003eLevel III, in addition to above qualifications: u003cbr /u003eu0026bull; AAS degree in Math, Economics or Business related field with a minimum of five years related experience. u003cbr /u003eu0026bull; Advanced knowledge of Underwriting rules and principles. u003cbr /u003eu0026bull; Advanced knowledge of health products and alternate financial arrangements available. u003cbr /u003eu0026bull; Advanced knowledge of federal/state laws/regulations relating to health insurance, such as COBRA, Medicare, HIPAA, Small Group Reform, Affordable Care Act, etc. u003cbr /u003eu0026bull; Advanced knowledge of federal/state tax forms and different business structures such as sole prop, tax exempt organizations, partnerships, limited liability companies, etc. u003cbr /u003eu0026bull; PC skills required: u003cbr /u003eo Advanced level in Microsoft Excel u003cbr /u003eo Proficient in Microsoft Word u003cbr /u003eo Ability to navigate on the internet for research purposes. u003cbr /u003eo Knowledge of Cognos or other data extraction tool u003cbr /u003eo Lotus Notes u003cbr /u003eo PowerPoint u003cbr /u003eu0026bull; Intermediate presentation skills. u003cbr /u003eu0026bull; Able to handle more complex projects. u003cbr /u003eu0026bull; Relies on instructions and pre-established guidelines to perform the functions of the job. Works with minimal supervision. u003cbr /u003eu0026bull; Working knowledge of all end to end processing for all systems as it applies to enrollment of members and groups (including those used by Sales, Marketing, Underwriting, and Inquiry units). u003cbr /u003eu0026bull; Full knowledge of all systems. u003cbr /u003e u003cbr /u003ePhysical Requirements u003cbr /u003eTravel across regions may be required. u003cbr /u003e u003cbr /u003e************u0026nbsp;u003cbr /u003eu0026nbsp;u003cbr /u003eIn support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position. u003cbr /u003e u003cbr /u003e u003cbr /u003eEqual Opportunity Employeru003c/pu003e

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