About This Role
<p>Responsibilities:</p><ul><li><p>Review lengthy or complex medical records (APS, lab reports, physician notes, hospital discharge summaries) and identify clinically significant findings relevant to underwriting risk.</p></li><li><p>Produce concise, standardized summaries highlighting diagnoses, chronic conditions, treatment timelines, medications, surgical history, and red-flag findings (e.g., cardiac, oncology, mental health, substance use).</p></li><li><p>Flag missing, unclear, or contradictory medical information that may require follow-up with the applicant, physician, or requester.</p></li><li><p>Apply consistent formatting/templates so underwriters can quickly locate key data points without reading full files.</p></li><li><p>Maintain strict confidentiality and compliance with HIPAA/data privacy and regional health-data regulations.</p></li><li><p>Collaborate with managers, leaders to clarify ambiguous cases.</p></li><li><p>Identify patterns or risk factors (e.g., recurring conditions, family history, lifestyle risks) that may affect premium calculation or policy terms.</p></li><li><p>Meet turnaround time (TAT) targets and quality benchmarks for each case reviewed.</p></li></ul><h1><b>Required Qualifications</b></h1><ul><li><p>Bachelor's degree in Nursing, Life Sciences, Pharmacy, or a related medical/health field (preferred); insurance/underwriting background is a plus.</p></li><li><p>Strong understanding of medical terminology, disease processes, and common lab/diagnostic reports.</p></li><li><p>Familiarity with life/health insurance underwriting guidelines and risk classification is an advantage.</p></li></ul><h1><b>Key Skills</b></h1><ul><li><p><b>Medical knowledge: </b>Ability to interpret clinical notes, lab values, imaging reports, and treatment histories.</p></li><li><p><b>Analytical thinking: </b>Ability to separate underwriting-relevant details from non-essential clinical noise.</p></li><li><p><b>Attention to detail: </b>Catching inconsistencies, missing data, or high-risk conditions that could impact policy decisions.</p></li><li><p><b>Written communication: </b>Producing clear, concise, jargon-appropriate summaries for non-clinical underwriters.</p></li><li><p><b>Time management: </b>Handling high case volumes while meeting strict TAT (turnaround time) commitments.</p></li><li><p><b>Confidentiality & compliance awareness: </b>Strict adherence to data privacy standards (HIPAA or regional equivalent).</p></li></ul>