PLADS Medical Underwriter

Company Details

Aflac, Incorporated

Job Summary

Underwrites insurance applications within strict guidelines set for the issuance of policies and takes action to approve or decline; reviews and processes requests for additional life and disability coverage; responds to medical, policyholder, and field force inquiries


Principal Duties & Responsibilities

  • Applying a broad knowledge of lines of business, undertakes assignments requiring a high level of underwriting technical expertise and proficiency, drawing on considerable experience at the underwriter level; evaluates unique situations that require extensive evaluation; monitors trends and identifies the need for new or revised procedures and practices
  • Independently appraises and clarifies, and then approves, or declines applications for insurance; within strict guidelines set for the issuance of policies; handles underwriting pend support; orders and reviews all requirements for underwriting; reviews and handles reinstatement and addition cases
  • Communicates underwriting decisions to associates, accounts, applicants, and/or internal departments; researches and responds in writing to requests for information about declined applications; researches and responds to customer requests and inquiries

  • Reviews and decodes confidential medical information; generates coding to be reported to the Medical Information Bureau; assists senior underwriter with special medical studies, reports, and product development initiatives

  • Performs quality checks on less experienced underwriters; completes trend analysis and reports findings to management; participates in the training and ongoing education of less experienced underwriters and internal business partners; evaluates processes and analyzes root cause and makes recommendations for improvements

  • Reviews and responds to claim review files; completes annual MIB review and audit; assists with updating and maintaining the Underwriting guidelines by LOB

  • Serves as the subject matter expert with latitude for guided action or decision-making regarding the day-to day services provided by the business unit or operational functions and team processes; interprets and applies division and organizational policies and procedures, and recommends changes or enhancements to procedures or processes

  • Provides coaching and mentoring on more complex application files to team members, and communicates training and performance needs to supervisors and employees; uses various evaluation and feedback methods (checking work, problem time, etc.) to measure and communicate performance status; ensures successful transition of new employees from training to the work environment

  • Performs other related duties as required


Education & Experience Required

  • Minimum Required Bachelor’s Degree In business administration or a related field Minimum Required 1- 3 years of insurance experience

  • Minimum Required 4 years of work-related experience that has provided a thorough understanding of underwriting principles and medical terminology/conditions


Education & Experience Preferred

  • FLMI (The Fellow, Life Management Institute), FALU (Fellow, Academy of Life Underwriting), or equivalent training and certification


Or an equivalent combination of education and experience


Job Knowledge & Skills

  • In-depth knowledge of underwriting principles and techniques
  • Skill in risk-selection principles, medical terminology, and human diseases and disorders as they relate to risk selection

  • Proficient personal computer skills using Microsoft office software

  • Excellent comprehension, writing, and grammar skills
  • Strong research, mathematical, and reasoning skills

  • Culturally sensitive and aware

  • Knowledge of Aflac products

  • Knowledge of Aflac systems
  • Microsoft Excel – Advanced

  • Microsoft Word – Advanced

  • Microsoft PowerPoint – Advanced
  • Access – Advanced
  • SharePoint – Advanced

  • Business Intelligence – Advanced


Competencies


  • Acting with Integrity
  • Communicating Effectively
  • Pursuing Self-Development
  • Serving Customers
  • Supporting Change
  • Supporting Organizational Goals
  • Working with Diverse Populations

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