Medical Underwriter

Roles & Responsibilities

? Review and process medical documentation and insurance claims to ensure accuracy, completeness, and compliance.

? Analyze patient information, laboratory findings, and treatment histories for risk assessment and decision-making.

? Determine coverage eligibility, exclusions, and appropriate premium modifications based on health risk profiles.

? Collaborate with healthcare providers, policyholders, and team members to resolve discrepancies and communicate outcomes.

? Guide acceptance or rejection of health proposals, applying robust risk evaluation techniques and recommending appropriate risk loading when necessary.

? Extract insights from Claims MIS and use data analytics to enhance underwriting

decisions.

? Monitor regulatory changes and industry trends to continuously improve risk evaluation processes.

? Contribute innovative ideas for process optimization and risk mitigation.

Required Skills & Competencies

? Strong foundation in medical science and clinical documentation.

? Expertise in health risk underwriting and claims assessment.

? Analytical mindset, detail orientation, and critical thinking skills.

? Ability to communicate clearly and collaborate with diverse stakeholders.

? Experience extracting and interpreting insights from claims data systems.

? Creative problem-solver, open to process innovation and improvement.

Qualification required: BAMS, BHMS