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Blue Cross and Blue Shield of Kansas · 23 hours ago

Underwriting Analyst

Kansas

Full-time

Hybrid

Mid Level

$30.96/hr - $38.70/hr

3+ years exp

Blue Cross and Blue Shield of Kansas is looking to add to their Underwriting team with a new opportunity for an Underwriting Analyst. This role is responsible for evaluating risk and eligibility for employer groups and individual business, ensuring compliance with underwriting guidelines and supporting underwriting decisions to mitigate financial risk.

Financial ServicesHealth Care

Growth Opportunities

Responsibilities

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 and consistent 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

Qualification

Underwriting experienceRisk assessmentRegulationsMedical terminologyAnalytical skillsCommunication skillsProblem-solving skillsMicrosoft OfficeOrganizational skillsAttention to detail

Required

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 required

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

Preferred

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 10 methodologies

Experience working with group rating, underwriting policies, and regulatory compliance preferred

Medical terminology coursework or experience in medical claims review is preferred