[Hiring] Medical Underwriting Nurse @Tokio Marine HCC

Role Description

Assess medical risk, predict and assign medical cost of care for claims and underwriting purposes.

Key Responsibilities

• Assess medical cost and clinical data utilizing multiple data sources and various software.
• Provide risk assessment and cost projections for underwriting and claims based on medical condition, treatment plan, and drug costs.
• Stay up to date with the latest medical advancements and how they affect cost projections and recommendations.
• Strong medical knowledge including International Classification of Diseases (ICD), Current Procedural Terminology (CPT), medical terminology, COBRA, and HIPAA.
• Strong understanding of third-party administrators (TPAs).
• Strong understanding of medical stop loss.

Qualifications

• Required Registered Nurse (RN) designation.
• 5 Years Relevant and progressive clinical experience, preferably in an acute care or managed care setting.
• Strong medical knowledge, including International Classification of Diseases (ICD), Current Procedural Terminology (CPT), medical terminology, COBRA, and HIPAA.
• Strong understanding of the operations of third-party administrators (TPAs) and managing general underwriters (MGUs).
• Knowledge of Carrier and Reinsurer reporting and contractual requirements.
• Possess and have ability to apply broad knowledge of principles, practices, and procedures.
• Excellent written and verbal communication skills with an emphasis on confidentiality, tact, and diplomacy.
• Exceptional organizational and analytical skills; demonstrated ability to manage multiple tasks simultaneously.
• Knowledgeable of industry changes, legal updates, and technical developments related to applicable area of the Company's business to proactively respond to changing business conditions.

Benefits

• Competitive salary and comprehensive benefit package.
• Strong learning culture with ongoing development opportunities.
• Opportunities for growth and career advancement.
• Comprehensive medical, vision, and dental coverage, with eligibility beginning on your first day of employment.
• Basic life and disability insurance.
• 401(k) plan with 6% company match.
• 20 days of PTO, two floating holidays, approximately 11 paid holidays, and volunteer time off.
• Paid parental leave.
• Access to our award-winning wellness program, including mental health services, fitness network membership, and a complimentary Headspace subscription.
• Student loan matching program.
• Employee discount program.
• An opportunity to do meaningful work and love what you do.

Company Description

Tokio Marine HCC is a leading specialty insurance group with offices in the United States, the United Kingdom, Europe, and other exciting locations. With the strength and stability that comes from being a member of the Tokio Marine Group, and more than fifty years of growth, profitability, and stability, we offer important insurance products that most people don’t even know exist. Every policy we write is special, enabling our clients to do amazing things.

For over 50 years, HCC Life Insurance Company, operating as Tokio Marine HCC – A&H Group, has been at the forefront of medical stop loss insurance. In addition to traditional stop loss, we offer captive and Taft-Hartley stop loss solutions, Organ & Tissue Transplant insurance, and MedPlus insurance. Tokio Marine HCC – A&H Group is rated A++ (Superior) by A.M. Best Company and benefits from the financial stability of its parent company, Tokio Marine HCC.

Applying our Mind Over Risk philosophy to writing insurance allows our customers to take on opportunity with confidence. That philosophy defines our way of thinking, unites us as a team, and differentiates us from our competitors. We are much more than just an insurance company; we are a good company.

Equal Opportunity Employer

TMHCC is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to age, ancestry, citizenship, color, family or medical care leave, gender identity, genetic information, marital status, medical condition, national origin, physical or mental disability, protected veteran or military status, race, ethnicity, religion, sex (including pregnancy), sexual orientation, or any other characteristic protected by applicable local laws, regulations, and ordinances.