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 underwritingdecisions.● 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

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