Company :Highmark Inc.Job Description : 

JOB SUMMARY

Analyzes risk factors for new enrollment, annual renewals, and amendments of group/individual insurance contracts or self funded plans in conformance with established underwriting policies, practices and standards.  

ESSENTIAL RESPONSIBILITIES

Responsible for a block of business (new or renewal) or for those new/renewing accounts assigned.Interpret risk and applies pricing policies to account for unusual situations.  Identify questionable claim patterns whether occurring on an inforce account or a prospect.Identify  unusual situations not anticipated by standard pricing formulae and seek assistance in applying Corporate Risk Management policies .Monitor compliance with Corporate Underwriting policies.Complete workload within established Production and Timeliness standards.Other duties as assigned.

EDUCATION

Required

Bachelor's Degree in Mathematics, Actuarial Science, Finance, Business, Computer Science or other quantitative analysis discipline

Substitutions

6 years of related experience in lieu of a Bachelor's Degree

Preferred

None

EXPERIENCE

Required

None

Preferred

1 year of relevant insurance industry experience

LICENSES OR CERTIFICATIONS

Required

None

Preferred

None

SKILLS

Ability to use computer systems, electronic tools, and applicationsAbility to manage several simultaneous prioritiesDemonstration of ethical business practices with adherence to guidelinesStrong attention to detailBasic analytical skills

Language Requirement (other than English)

None

Travel Required

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-Based

Teaches / trains others regularly

Rarely

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Does Not Apply

Physical work site required

No

Lifting: up to 10 pounds

Occasionally

Lifting: 10 to 25 pounds

Rarely

Lifting: 25 to 50 pounds

Never

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Referral Level Payout 1

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

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For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

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