Medical Underwriter Sr (Nurse Preferred) - Remote - 137915

Employer
Anthem, Inc
Location
Wallingford
Salary
Competitive
Posted
Feb 02, 2018
Closes
Feb 12, 2018
Industry
Education
Employer Type
Direct Employer
Employment Type
Permanent
Hours
Full Time
/ Your Talent. Our Vision. /* At Anthem, Inc., * it?s a powerful combination, and the foundation upon which we?re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will*drive the future of health care*.

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.

*Medical Underwriter Sr (Nurse Preferred) ? Remote - 137915*

*Location:* Any US location preferably near a main Anthem office location.

Responsible for determining acceptability of medically underwritten risks for more complex cases.

Primary duties may include, but are not limited to:

* * Calculates appropriate group/individual premium rates for new business and renewal in accordance with Corporate Underwriting Guidelines and federal and state statutes.

* * Proposes new business rates for complex cases ensuring rating compliance, utilizing a combination of medical applications, additional medical information, and manual rates.

* * Calculates renewal rates for complex cases utilizing a thorough analysis of medical experience, location, demographic nature, etc.

* * Evaluates medical information in order to assign appropriate underwriting decision.

* * Monitors and review rating compliance reporting with actuaries for assigned business.

* * Analyzes and responds to written and verbal underwriting inquiries.

* * Participates in and may lead special underwriting projects. Interacts frequently with brokers and sales, administration and actuarial areas.

* * Provides input to help calculate appropriate stop loss premium rates for new business and renewal in accordance with Corporate Underwriting Guidelines and federal and state statutes.

* * Proposes input for calculation of new business rates for stop loss cases ensuring rating compliance, utilizing a combination of medical applications, additional medical information, and manual rates.

* * Provides input to help calculate renewal rates for stop loss cases utilizing a thorough analysis of medical experience, location, demographic nature, etc.

* * Evaluates medical information in order to assign appropriate underwriting decision.

* * Ensures timely, accurate and consistent review of large claim reports, applying underwriting guidelines.

* * Analyzes and responds to written and verbal underwriting inquiries.

* * Participates in and may lead special underwriting projects.

* * Ensures the high risk member is referred to the appropriate clinical programs.

*

Requires a BA/BS in a related field; 3 years of related underwriting or clinical nursing experience; or any combination of education and experience, which would provide an equivalent background.

Preferred

* Nursing degree.

* Clinical or case management knowledge and experience in the areas of oncology, transplants or NICU.

* Billing and coding experience.

* Attention to detail and analytical skills.

* CPCU, CLU, LOMA, HIAA or other insurance related courses.

/ Anthem, Inc. is ranked as one of America?s Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran. /

**Job** *Underwriting*

Equal Employment Opportunity Statement
Anthem, Inc. will recruit, hire, train and promote persons in all job titles without regard to age, color, disability, gender (including gender identity), marital status, national origin, race, religion, sex, sexual orientation, veteran status, or other status protected by applicable law. In addition, all personnel actions such as compensation, promotion, demotion, benefits, transfers, staff reductions, terminations, reinstatement and rehire, company-sponsored training, education and tuition assistance, and social and recreational programs will be administered in accordance with the principles of equal employment opportunity.

**Title:** *Medical Underwriter Sr (Nurse Preferred) ? Remote - 137915*

**Location:** *connecticut-Wallingford*

**Other Locations:** *KY-Louisville, CO-Denver, FL-Plantation, NV-Las Vegas, Indiana, MO-St. Louis, Wisconsin, IN-Indianapolis, PA-Harrisburg, MN-Eagan, Colorado, VA-Richmond, ME-South Portland, CT-Wallingford, CA-Los Angeles, IL-Chicago, Georgia, OH-Cincinnati, TX-Grand Prairie, GA-Atlanta, TN-Nashville, WI-Waukesha, NY-Albany, NY-Middletown, Texas, Tennessee, Nevada, VA-Virginia Beach, Ohio, California, Florida*

**Requisition ID:** *137915*