Clinical Underwriting Manager

Job Description

Design a framework to gauge clinical risk for Insurance and Wellness
policy/ products sold by the organization
Develop the framework based on clinical understanding of medical reports, laboratory results, and other medical documentation to evaluate
and assign a health risk status for the target population
Analyze data to determine appropriate coverage and premium rates for insurance policies
Collaborate with the sales team to provide recommendations on insurance products and coverage options based on medical risk assessments
Provide guidance and support to the claims department in reviewing and processing claims
Stay up-to-date with the latest medical developments and industry trends in order to provide accurate and informed recommendations to the company
Identify and report any potential fraud or abuse in claims submissions and underwriting practices

Requirements

Medical degree or equivalent medical qualification (MBBS, MD, or equivalent)
Minimum of 5 years of experience in clinical underwriting in the insurance industry
Upto date with current clinical treatment protocols
Excellent analytical and problem-solving skills
Excellent communication and interpersonal skills
Ability to work independently and in a team environment
Strong attention to detail and accuracy
Ability to multitask and prioritize workload
Proficient in Microsoft Office and other relevant software applications