Individual Medical Underwriter - Medicare Supp

At Blue Cross and Blue Shield of Nebraska, we are a mission-driven organization dedicated to championing the health and well-being of our members and the communities we serve.

Our team is the power behind that promise. And, as the industry rapidly evolves and we seek ways to optimize business processes and customer experiences, there's no greater time for forward-thinking professionals like you to join us in delivering on it! As a member of Team Blue, you'll find purpose, opportunities and the support you need to build a meaningful career and make a powerful impact in our community.

Candidates applying to this position may be hybrid or remote and can live in one of the following states: Florida, Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, and Texas.

This position will medically underwrite and rate applications for individual products (to include Medical Supplement policies as assigned) evaluating health history information and medical records to apply medical underwriting guidelines consistently. The individual will also review and facilitate the process for reconsideration requests regarding previous underwriting decisions.

What you'll do:

• Responsible for the accurate and timely review of medical documentation to assess an applicant's current health status and eligibility for coverage according to medical underwriting guidelines for individual products, using computer-based tools and documents
• Request and analyze medical records, focusing on medical conditions that can affect morbidity/differential diagnoses, to the degree applicable to the insurance product
• Collaborate with coworkers regarding the interpretation of medical records and assigning to appropriate medical underwriting guidelines
• Research complex applicant appeals. Review additional medical records submitted for reconsideration and determine if a rating decision should change
• Communicate rating and appeal decisions to customers, brokers, and Sales/Account Management employees through formal and informal channels
• Communicate with other departments, responding to questions regarding the customer's application status

To be considered for this position, you must have:

• Bachelor's degree in business or medical field required and three (3) years' experience in Medicare Supplement underwriting

• Knowledge of medical terminology

• Strong analytical ability and problem-solving skills

• The ability to appraise risks and judge the cost/benefit of accepting applications

An equivalent combination of education and experience may be substituted for this requirement. The ability to meet or exceed the attendance and timeliness requirements of their departments.

The ability to work well in a team environment and be capable of building and maintaining positive relationships with other staff, departments, and customers.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and or ability required.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Other duties may be assigned.

The strongest candidates for this position will also possess:

• Graduate of an accredited school of nursing with a current and valid Registered Nurse license from the State of Nebraska, or a state within the consortium in which Nebraska participates
• Experience with automated/online underwriting systems

Learn more about what makes BCBSNE such an exceptional place to work by visiting NebraskaBlue.com/Careers.

We strongly believe that diversity of experience, perspective and background will lead to a better workplace for our employees and a better product for our customers and members.