Description
Temporary Employees: Are not eligible to apply for internal positions posted on the Intranet. Temporary employees are eligible to apply for any opportunities posted externally on the Internet at www.bcbsla.com once they have completed the minimum hours requirement in the temporary position.
Internal Applicants: Must meet the following two criteria in order to apply:
1. In their current job for 12 months
Where there is a formal classroom training program such as with customer service and claims processing jobs, the 12 month period will begin when the employee completes the training program and enters the job on a full time basis
2. In good standing(no disciplinary action and no rating of Needs Improvement on most recent review)
Applicants from within the department requesting the position are not required to meet the twelve-month criteria if the posted position is part of a natural career progression.
QUALIFICATIONS:
RN licensed to practice in Louisiana.
4 years of related experience, two years involving health or life underwriting preferred.
Able to understand and analyze medical terminology, related codes, diagnoses and procedures.
Must be able to effectively interpret guidelines of current state, federal and corporate regulations.
Working knowledge of relative software and CRT functions.
Excellent analytical, organizational, and interpersonal skills.
Must remain diplomatic when dealing with internal and external customers.
ACCOUNTABILITIES:
Reviews all evidence of insurability on individual health applications and benefit change requests to ensure appropriate underwriting of individual business.
Assists in the work by researching and resolving cases of misrepresentation to ensure fraud is minimized. May be called upon to defend medical decisions in court cases.
Serves as medical resource to the departmental management and to the group underwriters to interpret medical information, determine the need for the additional information, evaluate prognoses on risk factors and assist in determining severity of risk factors to support good underwriting actions.
Responds to written inquiries regarding riders, rejections or other underwriting action to maintain customer understanding and satisfaction.
Communicates with agents, subscribers and physicians to obtain information to support the underwriting decisions or to advise them of underwriting policies and procedures.
This position reports to the Manager of Medical Underwriting.
This position is a grade 13. The starting minimum salary is $4,159.42/mo.
Details:
Job Id:
18873407
Annual Salary:
Position Type:
Education Level:
No Selection
Experience Level:
No selection
Posted:
2/6/2010 2:38:14 AM
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