Job description
POSITION SUMMARY
This position is responsible for the generation of rate proposals for new business and renewal cases for all medical, pharmacy and ancillary products sold by Capital BlueCross and subsidiary companies.
Responsibilities in addition to renewal and new business rate proposal generation include; pricing of alternate benefit sets using actuarial based pricing models, evaluation of large claimant impacts, and consultation and interaction with cross functional areas such as Actuarial, Sales, Clinical and A&R.
This position functions as a consultant by providing advice to Sales and Account Executives, presenting information to groups and brokers, and providing department management with opinions of the financial consequences of existing or proposed insurance arrangements. Mathematical, financial and analytical skills are utilized to research data, develop projections and formulate appropriate proposals and recommendations to achieve business objectives.
The position is also responsible for approving the financial contract pages for renewing groups. Written and verbal communication skills along with subject matter expertise are used to support a consultative approach directed at understanding and meeting customer needs.
This position is responsible for the generation of rate proposals for new business and renewal cases for all medical, pharmacy and ancillary products sold by Capital BlueCross and subsidiary companies.
Responsibilities in addition to renewal and new business rate proposal generation include; pricing of alternate benefit sets using actuarial based pricing models, evaluation of large claimant impacts, and consultation and interaction with cross functional areas such as Actuarial, Sales, Clinical and A&R.
This position functions as a consultant by providing advice to Sales and Account Executives, presenting information to groups and brokers, and providing department management with opinions of the financial consequences of existing or proposed insurance arrangements. Mathematical, financial and analytical skills are utilized to research data, develop projections and formulate appropriate proposals and recommendations to achieve business objectives.
The position is also responsible for approving the financial contract pages for renewing groups. Written and verbal communication skills along with subject matter expertise are used to support a consultative approach directed at understanding and meeting customer needs.
DUTIES & RESPONSIBILITIES
- Prepares rate quotations for prospective groups or changes to benefits for current policyholders by applying Capital Blue Cross (CBC) underwriting requirements using various PC and mainframe based software packages.
- Prepares rate renewals for most CBC coverage and financial arrangements.
- Consults with Sales, Sales Management and Underwriting Management in support of renewal rate actions and quotes.
- Completes assignments in an accurate and timely manner with a high degree of attention to detail.
- Researches all necessary records and procedures for the calculation, and presentation of all rates.
- Reviews and approves financial contract language for renewing groups.
- Provides consultative support and technical guidance to process stakeholders.
- Occasionally assists in the presentation of proposals to external customers.
- Assists or participates in various special projects assigned by department management or under the supervision of a Sr. Underwriter.
- Assists in the underwriting analysis and response to special policyholder requests.
JOB REQUIREMENTS
Education:
- Prefer a Bachelor's Degree in Mathematics, Statistics, Accounting or a related business field
Knowledge:
- Knowledge of microcomputer applications used in the rating process.
- Knowledge of financial and accounting concepts, terminology and reports.
- Competent understanding of managed care theory and familiarity with the PA insurance regulatory environment.
Skills:
- Strong analytical skills and a sound understanding of medical statistics, enrollment and provider data.
- Ability to abstract a financial arrangement into theoretical mathematical structures.
- Ability to effectively explain technical issues and provide consultative services to internal and external stakeholders in both a written and verbal format.
Physical Demands:
- Sedentary work involving significant periods of sitting, talking, hearing, keying and performing repetitive motions.
- Work requires visual acuity to perform close inspection of written and computer generated documents as well as a PC monitor.
- Working environment includes typical office conditions.
Capital Blue Cross is an independent licensee of the Blue Cross Blue Shield Association. We are an equal opportunity/affirmative action employer and do not discriminate on the basis of race, color, religion, national origin, gender, sexual orientation, gender identity, age, genetic information, physical or mental disability, veteran status, or marital status, or any other status protected by applicable law.
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