Blue Cross and Blue Shield of Kansas
Underwriting Analyst
Blue Cross and Blue Shield of Kansas, Topeka, Kansas, United States, 66652
Overview
Blue Cross and Blue Shield of Kansas is looking to add an Underwriting Analyst to our Underwriting team. The analyst evaluates risk and eligibility for employer groups and individual business, ensuring compliance with underwriting guidelines and regulatory requirements. This role supports underwriting decisions to mitigate financial risk and collaborates with Sales, Membership, Rating, Actuarial, Legal, and Compliance teams.
Remote Work This position is eligible to work remotely, hybrid, or onsite in accordance with our Telecommuting Policy. Applicants must reside in Kansas or Missouri or be willing to relocate as a condition of employment.
Benefits
Family Comes First:
Total rewards package that promotes the idea of family first for all employees.
Professional Growth Opportunities:
Advance your career with ongoing training and development programs.
Dynamic Work Environment:
Collaborate with a team of passionate and driven individuals.
Trust:
Work for one of the most trusted companies in Kansas.
Compensation $30.96 - $38.70 per hour
Non‑exempt Grade 14. Compensation is a good faith estimate and may vary.
What you’ll do
Evaluate group and individual applications to ensure compliance with underwriting eligibility and participation requirements.
Assess health risk factors for individuals and employer groups, analyzing claims history and financial impact.
Conduct re‑rate reviews for groups with census changes, ensuring alignment with underwriting policies.
Serve as a liaison between underwriting and Sales, Membership, Legal, and Compliance, ensuring clear communication of underwriting decisions.
Maintain accurate records and documentation for audits and regulatory compliance.
Investigate complex eligibility cases, including rescission reviews, coordinating with legal and compliance as needed.
Provide underwriting guidance and training to internal teams on enrollment, eligibility, and underwriting policies.
Conduct quality assurance reviews of underwriting decisions to identify trends and improve processes.
Support the development and maintenance of underwriting policies and procedures to ensure compliance with ACA, COBRA, ERISA, and other regulations.
Assist with rate justifications and regulatory filings as needed.
What you need
High school diploma or equivalent.
Minimum of 3 years of experience in underwriting, enrollment risk assessment, or a related field in the health insurance industry.
Knowledge of medical terminology.
Knowledge, Skills, & Abilities
Strong analytical skills to assess risk, evaluate claims data, and make sound underwriting decisions.
Proficiency in medical terminology, risk assessment methodologies, and underwriting guidelines.
Understanding of state and federal regulations, including ACA, COBRA, and ERISA.
Excellent written and verbal communication skills to explain underwriting decisions and collaborate with internal and external stakeholders.
Strong problem‑solving skills to investigate complex enrollment and eligibility cases.
Ability to work independently while managing multiple priorities in a fast‑paced environment.
Proficiency in Microsoft Office applications (Word, Excel, Outlook) and familiarity with underwriting and enrollment systems.
Attention to detail and strong organizational skills to ensure compliance and accurate recordkeeping.
Bonus if you have
Bachelor’s degree in Business, Finance, Healthcare Administration, or a related field (preferred).
Preferred LPN, Certified Nurses Aid or Certified Medical Aid and/or experience in a clinical setting or coding medical records using ICD‑9 or ICD‑10 methodologies.
Experience working with group rating, underwriting policies, and regulatory compliance (preferred).
Medical terminology coursework or experience in medical claims review (preferred).
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Remote Work This position is eligible to work remotely, hybrid, or onsite in accordance with our Telecommuting Policy. Applicants must reside in Kansas or Missouri or be willing to relocate as a condition of employment.
Benefits
Family Comes First:
Total rewards package that promotes the idea of family first for all employees.
Professional Growth Opportunities:
Advance your career with ongoing training and development programs.
Dynamic Work Environment:
Collaborate with a team of passionate and driven individuals.
Trust:
Work for one of the most trusted companies in Kansas.
Compensation $30.96 - $38.70 per hour
Non‑exempt Grade 14. Compensation is a good faith estimate and may vary.
What you’ll do
Evaluate group and individual applications to ensure compliance with underwriting eligibility and participation requirements.
Assess health risk factors for individuals and employer groups, analyzing claims history and financial impact.
Conduct re‑rate reviews for groups with census changes, ensuring alignment with underwriting policies.
Serve as a liaison between underwriting and Sales, Membership, Legal, and Compliance, ensuring clear communication of underwriting decisions.
Maintain accurate records and documentation for audits and regulatory compliance.
Investigate complex eligibility cases, including rescission reviews, coordinating with legal and compliance as needed.
Provide underwriting guidance and training to internal teams on enrollment, eligibility, and underwriting policies.
Conduct quality assurance reviews of underwriting decisions to identify trends and improve processes.
Support the development and maintenance of underwriting policies and procedures to ensure compliance with ACA, COBRA, ERISA, and other regulations.
Assist with rate justifications and regulatory filings as needed.
What you need
High school diploma or equivalent.
Minimum of 3 years of experience in underwriting, enrollment risk assessment, or a related field in the health insurance industry.
Knowledge of medical terminology.
Knowledge, Skills, & Abilities
Strong analytical skills to assess risk, evaluate claims data, and make sound underwriting decisions.
Proficiency in medical terminology, risk assessment methodologies, and underwriting guidelines.
Understanding of state and federal regulations, including ACA, COBRA, and ERISA.
Excellent written and verbal communication skills to explain underwriting decisions and collaborate with internal and external stakeholders.
Strong problem‑solving skills to investigate complex enrollment and eligibility cases.
Ability to work independently while managing multiple priorities in a fast‑paced environment.
Proficiency in Microsoft Office applications (Word, Excel, Outlook) and familiarity with underwriting and enrollment systems.
Attention to detail and strong organizational skills to ensure compliance and accurate recordkeeping.
Bonus if you have
Bachelor’s degree in Business, Finance, Healthcare Administration, or a related field (preferred).
Preferred LPN, Certified Nurses Aid or Certified Medical Aid and/or experience in a clinical setting or coding medical records using ICD‑9 or ICD‑10 methodologies.
Experience working with group rating, underwriting policies, and regulatory compliance (preferred).
Medical terminology coursework or experience in medical claims review (preferred).
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